top of page
Financial and Insurance top of page
What about paying for treatment?

Please familiarize yourself with the information that follows.

If you have any questions, please feel free to ask one of our business office staff.

 

Please be aware that the parent bringing the child to the Smile Galaxy office is legally responsible for payment of all charges.

We cannot send statements to other persons.

 

  • Payment for any co-pays or deductible is expected in full for each appointment as services are rendered. For the convenience of our patients, we accept cash, MasterCard, VISA, American Express, Discover & Care Credit.

  • Pre-treatment Authorization: Some insurance companies recommend an estimate of the work to be done and the fees to be charged before determining their benefits to you. If so, we will provide you with the pre-treatment fee estimate. In this case, it will be up to you to determine if you wish to proceed with treatment before the insurance benefit is determined.

  • We recognize that under unusual circumstances an account balance may be incurred. Smile Galaxy requires that all outstanding balances be paid in full within thirty (30) days unless other arrangements have been made. Thank you in advance for your understanding of our financial policy!

 

What about dental insurance?

We appreciate you allowing us to provide dental care for your child. As we strive to be one of Oklahoma City’s leading providers for pediatric dental care, we will work to assist parents in taking an active role in their child's dental health. Because we value our relationship with you and believe that the best relationships are based upon understanding, we offer these clarifications on methods of payment & insurance reimbursement. 

 

  • We are in-network PPO Providers for Delta Dental, Cigna, Health Choice, Aenta PPO 1 & 2, Humana and Assurant, and GEHA Connection Dental Network.

  • We also file out-of-network PPO dental claims for most other dental insurance plans.

 

Upon your first visit, we will request a copy of your dental insurance information to allow us to file your claim for this and all future visits. Please remember to bring all dental insurance information, as well as insurance card(s). We also ask that you contact us immediately after making any changes to your dental coverage, so we can keep our records current and to provide expeditious reimbursement of your benefits.

 

If any treatment needs are discovered during your child’s exam,

we will provide you with a cost estimate indicating our total fee, what we anticipate your insurance coverage to be, and your estimated out-of-pocket portion for the treatment plan. We will discuss all treatment and cost before beginning any further treatment. Please remember, our office is here for you.

Feel free to contact us with any insurance or payment questions.

Tips concerning dental insurance

We are dedicated to providing all our patients with the best treatment available and base our treatment recommendations on what will be best for your child and not what your insurance company does or doesn't pay. Please note the following in regards to your dental insurance coverage:

 

  • We must emphasize that as a health care provider, our relationship is with you and not your dental insurance company. Your dental insurance is a contract between you, your employer and the insurance company. Most plans routinely pay between 50-75% of the average total fee for a given procedure. This percentage is pre-determined by the plan your employer has purchased.  

  • As a courtesy, we will be happy to file for your insurance benefits. Because your dental insurance plan is a contract between you, your employer, and the insurance company, many carriers will not reimburse our office. In this instance, you will be responsible for the full cost of each visit at the time services are provided and your insurance company will send you the reimbursement check directly.

  • Any amount not covered by your insurance company is payable at the time services are rendered; these fees may include deductibles, co-payments or certain procedures not covered by your insurance policy. Unfortunately, some of the services that we may recommend for your child will not be covered by your specific dental insurance. Our primary goal is to treat your child using the best possible materials, supplies, medications and environment.

  • We allow a maximum of 45-days for your insurance company to clear account balances. Any unpaid portions will be due in full, by you, after this period. If you have not paid your balance within 60 days of the date treatment was rendered a finance charge of 1.5% will be added to your account each month until paid. Should your insurance company submit payment after this time, we will be glad to reimburse you.  

  • Our office does not determine your dental benefits. Your employer chooses your particular policy. If you are unhappy with its coverage, this should be mentioned to your employer’s benefits coordinator. Only your employer can adjust benefits.

(405) 692-1222

We're here to serve you and your family!

9801 S Pennsylvania Ave, Oklahoma City

How do I pay for this?

For your convenience we accept cash as well as all major credit cards (Visa, MasterCard, American Express, Discover Card and Care Credit). 

 

Financing Programs

If you do not have dental insurance, or if you have insurance but your treatment plan indicates significant treatment and cost, you can apply a low monthly payment financing plan through www.carecredit.com or call 1-(800) 677-0718 This is a great option and you can do it in the privacy of your own home.

 

We will always do our best to maximize the insurance benefits that you are eligible to receive and we appreciate your prompt settlement of any charges that may be incurred during the treatment process. We look forward to years of close association with you, as we work together to maintain your child's oral health! 

 

Facts about your insurance plan

Fact 1: NO INSURANCE PAYS 100% OF ALL PROCEDURES

Dental insurance is meant to be an aid in receiving dental care. Many patients think that their insurance pays 90%-100% of all dental fees. This is not true! Most plans only pay between 50%-80% of the average total fee. Some pay more, some pay less. The percentage paid is usually determined by how much you or your employer has paid for coverage or the type of contract your employer has set up with the insurance company.

 

Fact 2: BENEFITS ARE NOT DETERMINED BY OUR OFFICE

You may have noticed that sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist's actual fee. Frequently, insurance companies state that the reimbursement was reduced because your dentist's fee has exceeded the usual, customary, or reasonable fee ("UCR") used by the company.

 

A statement such as this gives the impression that any fee greater than the amount paid by the insurance company is unreasonable or well above what most dentists in the area charge for a certain service. This can be very misleading and simply is not accurate. Insurance companies set their own schedules and each company uses a different set of fees they consider allowable. These allowable fees may vary widely because each company collects fee information from claims it processes. The insurance company then takes this data and arbitrarily chooses a level they call the "allowable" UCR Fee. Frequently this data can be outdated and the insurance company sets these “allowable” fees so they can make a net profit.

 

Unfortunately, insurance companies imply that your dentist is "overcharging" rather than saying that they are "underpaying" or that their benefits are low. In general, the less expensive insurance policy will use a lower usual, customary, or reasonable (UCR) figure.

 

Fact 3: DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED

When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume the fee for service is $150.00. Assuming that the insurance company allows $150.00 as its usual and customary (UCR) fee, we can figure out what benefits will be paid. First a deductible (paid by you), on average $50, is subtracted, leaving $100.00. The plan then pays 80% for this particular procedure. The insurance company will then pay 80% of $100.00, or $80.00. Out of a $150.00 fee they will pay an estimated $80.00 leaving a remaining portion of $70.00 (to be paid by the patient). Of course, if the UCR is less than $150.00 or your plan pays only at 50% then the insurance benefits will also be significantly less.

Financial & Insurance Info

bottom of page