
Soudabeh Sharafi,
D.M.D.
12750 Carmel Country Road,
Ste 215
San Diego, California 92130
PH: (858)
259-1400
FAX: (858) 259-1401
Email:
info@delmarpedo.com
Office Hours
M-F: 8:00a.m. - 5:00p.m.
Sat.: 8:00a.m. - 1:00p.m.
(By appointment only)
How are
Appointments Scheduled?
Do I
Stay with My Child During the Visit?
What About
Finances?
Our
Office Policy Regarding Dental Insurance
How are Appointments
Scheduled?
Our office attempts to
schedule appointments at your convenience and when time is
available. Preschool children should be seen in the morning
because they are fresher and we can work more slowly with
the child for their comfort. School children with a lot of
work to be done should be seen in the morning for the same
reason. Dental appointments are an excused absence. Missing
school can be kept to a minimum when regular dental care is
continued.
Since appointed times are reserved
exclusively for each patient we ask that you please notify
our office 24 hours in advance of your scheduled appointment
time if you are unable to keep your appointment. Another
patient who needs our care could be scheduled if we have
sufficient time to notify them. We realize that unexpected
things can happen, but we ask for your assistance in this
regard.
Do I Stay with My
Child During the Visit?
We ask that you allow your child to
accompany our staff through the dental experience. We are
all highly experienced in helping children overcome anxiety.
Separation anxiety is not uncommon in children, so please
try not to be concerned if your child exhibits some negative
behavior. This is normal and will soon diminish. Studies and
experience have shown that most children over the age of 3
react more positively when permitted to experience the
dental visit on their own and in an environment designed for
children.
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What About Finances?
Please ask our office staff if you are
interested in applying for CARE CREDIT FINANCING. This card
allows you to pay your child's balance at zero interest to
you for a 12-month period.
Payment for professional services is
due at the time dental treatment is provided. Every effort
will be made to provide a treatment plan which fits your
timetable and budget, and gives your child the best possible
care. We accept cash, personal checks, debit cards and most
major credit cards.
Our Office Policy
Regarding Dental Insurance
If we have received all of your
insurance information on the day of the appointment, we will
be happy to file your claim for you. 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 30 days of receipt. We file all insurance
electronically so your insurance company will receive each
claim within days of the treatment. You are responsible for
any balance on your account after 30 days, whether insurance
has paid or not. If you have not paid your balance within 60
days a re-billing fee of 1.5% will be added to your account
each month until paid. We will be glad to send a refund to
you if your insurance pays us.
PLEASE
UNDERSTAND that we file dental insurance as a courtesy to
our patients. We do not have a
contract with your insurance company, only you do. We are
not responsible for how your insurance company handles its
claims or for what benefits they pay on a claim. We can only
assist you in estimating your portion of the cost of
treatment, we at no time guarantee what your insurance will
or will not do with each claim. We also can not be
responsible for any errors in filing your insurance, once
again we file claims as a courtesy to you.
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 three to five years old and these "allowable" fees are
set by the insurance company so they can make a net 20%-30%
profit.
Unfortunately, insurance companies imply that your 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 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.
MOST IMPORTANTLY, please keep us
informed of any insurance changes such as policy name,
insurance company address, or a change of employment.
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