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Livingston Pediatric Dental Associates

Pediatric Dentistry for Infants, Children, Adolescents and Special Needs Patients

Office Information

How are Appointments Scheduled?

The 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. Missing school can be kept to a minimum when regular dental care is continued.

Since appointed times are specially reserved for your child, we ask that you make every effort to arrive promptly, and please notify our office 24 hours in advance of your scheduled 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. Please realize that since all our patients are children, we cannot promise afterschool times to everyone but we will try to be as accommodating as possible.

Do I stay with my child during the visit?

Parents are invited to participate in the child's dental visit. On some occasions, a child might benefit from separation during the visit. We may suggest using the parent as a “reward” for good behavior. The child will come back alone and the parent will be invited to come back after a few minutes. If this is the case, we ask that you allow our staff to accompany your child through the dental experience.

What about Finances?

We have determined reasonable fees for the professional services we provide. Fees are based on the treatment necessary and the time required for completion of the treatment, depending on the individual case. Since billing is a costly and time consuming practice we respectfully request payment at the time these services are rendered. If extenuating circumstances prevent prompt settlement of your account with us, please discuss this with us personally so that we can make the necessary arrangements.

Please be aware that the parent bringing the child to our office is legally responsible for payment of all charges. Payment is due at the time that services are rendered and can be made by cash, check, Visa, and Mastercard. We are Delta Dental Premier and PPO Plus Plan Participants. Every effort will be made to provide a treatment plan which fits your timetable and budget, and gives your child the best possible care.

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 for it 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 the outstanding balance is 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. 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 do not guarantee what your insurance will or will not do with each claim. We are 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 your insurance company.

Fact 2 - BENEFITS ARE NOT DETERMINED 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 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 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 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 fees are set by the insurance company so they can net a 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 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 service fee 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 averages $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.

Livingston Pediatric Dental Associates in Livingston, NJ

Dr. Shari Summers is a pediatric dentist in Livingston, NJ serving infants, children, teens and special needs patients. The office also serves the cities of Millburn, Short Hills, West Orange, NJ and other surrounding cities.

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315 East Northfield Road
Livingston, NJ 07039

Ph: 973-992-5555
Fax: 973-992-1166