Appointment Policies
How are Appointments Scheduled?
Our office attempts to schedule appointments for the most comfortable and efficient care for your child. As the day progresses children become more stressed and less rested; a visit to the dentist can add to this stress causing worry. Preschool children should be seen in the morning, before any nap times, at these times we can work more slowly with them to assure their comfort. School children with a lot of homework should be seen in the morning for the same reason. Dental appointments are an acceptable excused absence noted in the Texas Education Code and we will provide a note to take back to school documenting the healthcare appointment. Missing school can be minimal when regular dental care is scheduled.
Once made, your appointment time is reserved exclusively for your child or your children. We work very hard and take pride on staying on time and we ask that you extend the same courtesy to us. However, please recognize that are goal is to have a positive experience with every child we treat and for this reason we remind you we work on “child time” and sometimes our appointments my not begin or end at the exact time we schedule. Sometimes unexpected needs arise that require us to spend more time with a child than anticipated. If upon your arrival we are not on schedule we will let you know so that you may make the decision to be seen as soon as we are able or reschedule the appointment. We ask that you be understanding knowing we will treat your child with the same respect and we always want to provide the highest quality of care with the greatest attention to each patient.
If you arrive more than 15 minutes past your scheduled appointment time, you may be asked to reschedule so that other patients are not inconvenienced. If you cannot keep an appointment, please notify us immediately. It may be difficult to reschedule you the same day or even the same week since most appointments are made several weeks in advance.
New patients are scheduled so that we have approximately 45 minutes to an hour for their appointment; these appointments are routinely scheduled around 10:30 am or 1:30 pm.
Appointments for Dental Treatment
If it is determined that your child needs dental treatment an appointment will be arranged taking several factors into consideration. Young children are better dental patients when they are scheduled early in the day before they have become tired. For this reason young children are scheduled in the morning, reserving the later after lunch and afterschool appointments for middle school and high school students. Yes, your child will become a middle school and then high school student sooner than you think.
Dr. West does not perform any procedure requiring anesthesia for school age children after 2:30 pm. Since anesthesia needs approximately 1 – 1½ hours to “wear off” there needs to be several hours for that to occur before eating dinner thus avoiding the chance of biting a numb lip, cheek or tongue.
Dr. West performs procedures requiring Nitrous-Oxide and Oxygen in the morning prior to lunch. If your child requires Conscious or I.V. Sedation these appointments will be scheduled for the first appointment of the day.
During all restorative procedures we ask that the parent remains in the reception area so that Dr. West can communicate directly with your child, rather than trying to communicate with your child through you the parent.
My Child Attends School
Almost all of our patients attend school outside the home and most of their parents work; therefore you should know that the Texas Education Code Section 25.087(b) specifically addresses the issue of temporary absences resulting from appointments with health care professionals. Temporary absences for dental visits are EXCUSED ABSENCES. Students must be given a reasonable time to make up schoolwork missed and if successful and satisfactorily completed the student may not be deprived of a benefit based on “perfect attendance”, and the temporary absence shall be counted as a day of compulsory attendance. Additionally, in August of 1999, the Texas Attorney General, John Cornyn, stated this Section of the Texas Education Code established that “perfect attendance” benefits could not be denied to any student, if in fact the absence complied with this section of the Texas Education Code.
School Excused Absence Note
At the conclusion of your appointment Dr. West will complete a School Excused Absence note that should be delivered to school attendance office upon return to school. This note will verify that you have been at a health care appointment and the Texas Education Code Section 25.087 (b) outlines how this absence should be recorded. If for some reason the school does not adhere to these rules the issue should be discussed with the Superintendant of the respective school district.
What About Finances
Our dental practice aims to provide the highest quality care at affordable prices. Every effort will be made to provide a treatment plan that gives you the best possible care, and fits into your timetable and budget. Payment for dental services is due at the time that treatment is provided. We accept cash, personal checks, debit cards, Visa and Mastercard.
Our Office Policy Regarding Dental Insurance
Our office accepts most major insurance plans and will file a claim for you as a courtesy. We will provide you a completed insurance claim form for all procedures performed if you have provide complete and accurate information concerning your dental insurance on or before the day of your appointment. It is your responsibility to inform us of any changes concerning your insurance coverage. Our office will accept assignment of benefits if you complete all the insurance information needed to accurately process the insurance claim and the “Authorization to Bill Outstanding Balance” section of the Patient Information Form. You must be familiar with your insurance benefits, as we will collect from you the estimated amount insurance is not expected to pay. By law, your insurance company is required to pay each claim within thirty (30) days of receipt of the claim. You are responsible for any balance on your account after sixty (60) days, whether the insurance has paid or not. We will be glad to send a refund to you if your insurance pays us.
PLEASE UNDERSTAND that we are not responsible for how your insurance company handles its’ claims, or for the benefits they pay on a claim. We do not have a contract with your insurance company. Because insurance policies vary, we can only estimate your benefits in good faith. We do not guarantee what your insurance will do with each claim due to the complexities of insurance contracts. We will provide an accurate claim for the services provided, however, we are not responsible for any errors in filing your insurance due to the information you provide concerning coverage. We require specific information during your registration as a patient to assure proper filing of claims. If the information provided to us has inaccuracies are omissions your claim will be negatively impacted and you will be responsible for the fees for all services provided.
Once again, we file insurance for our patients as a courtesy, and do not control the amount your insurer covers.
Fact 1 – NO INSURANCE POLICY 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. Think of your auto insurance – you have choices from minimal coverage to maximum coverage. The insurance company is responsible to the policy holder, and the policy holder is financially obligated to the doctor. We will help in every way we can in filing your claim and handling insurance questions from our office on your behalf.
Fact 2 – BENEFITS ARE NOT DETERMINEED BY OUR OFFICE
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 fees have 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 is not accurate.
Insurance companies set their own schedules, and each company uses a different set of fees they consider reasonable. These reasonable fees may vary, because each insurance 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 three (3) to five (5) years old and these fees are set by the insurance company so they can generate a profit. A prime example is that orthodontic benefits have been 50% of the total fee up to a lifetime maximum of $1000.00 - $2000.00 for over thirty (30) year meaning they only have to pay up to the lifetime maximum. Premiums charged for orthodontic benefits have not remained the same for the same time period.
Unfortunately, insurance companies imply that the dentist is overcharging, rather than say that they are underpaying, or that their benefits are low. In general, the less expensive insurance policy will use a lower reasonable (UCR) figure.
Fact 3 - DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED
When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume a dental service fee Is $150.00. Assuming that the insurance company allows $150.00 as its’ usual and customary (UCR) fee, benefits will be determined by first determining if a deductible must be met. The average deductible is $50.00, so subtract $50.00 from $150.00, this leaves $100.00. The plan then pays 80% of $100.00 or $80.00. Out of a $150.00 fee they will pay an estimated $80.00 leaving a remaining balance of $70.00 (to be paid by the policy holder/patient). Of course, if the UCR is less than $150.00, or if your plan pays only 50% then the insurance benefit will be significantly less.
MOST IMPORTANTLY, please keep us informed of any insurance changes such as policy name, insurance company address, or a change of employment.
