Q. What should I bring to my first visit?

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A. For your first appointment, we request that you arrive fifteen minutes early to complete necessary paperwork. If you’ve already filled out our online forms, we recommend arriving just five minutes prior to your appointment.

Please bring up-to-date dental and medical insurance cards, as we will make copies of both to have on file for future reference. Although we try our best to provide accurate out-of-pocket cost estimations, we advise you read through your insurance policy on your own so that you understand what services will and will not be covered. If you have any questions, we recommend you call your insurance company prior to the appointment, or arrive twenty minutes early to review your insurance policy with us.

Your first appointment is scheduled with a hygienist, but includes a comprehensive examination by a dentist. The appointment will take roughly seventy minutes.

Q. What do I do if my dental insurance changes?

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A. Even a minor change can interfere with insurance claim processing. For example, your employer may have changed the plans offered (something they should inform you of), or the insurance company itself may have made an update to your current plan.

If there is an update to your dental insurance, we ask that you notify us immediately, as even small changes can impact your out-of-pocket expenses. Even changes to the plan’s group number or your subscriber ID number can cause issues – in this case, your claim could be denied for incorrect information.

In the event of a denied claim, we attempt to contact our patients for updated information; however, relying on us in this manner is risky, as some plans won’t accept claims after a certain time period, whether there’s coverage or not. To prevent any of these situations, please be prepared to verify your insurance at every visit.

Looking for an alternative to dental insurance? Learn more about our Dental Membership Program, which includes dental discount plans.

Q. Why was my dental insurance claim denied?

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A. Your dental insurance carrier can deny a claim for the following reasons:

Q. How does Madison Family Dental Associates file claims?

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A. On the same day that you receive service, we file our claims using a secure website, unless an insurance carrier cannot receive electronic claims. The next day, a claim is generated.
If you require major restorative procedures, your insurance company may require an x-ray, detailed information on why the procedure was completed, or periodontal charting. We may also need additional information from you regarding previous dental services or, in the event of a missing tooth, how long the tooth has been missing.

Q. Can dental insurance companies limit coverage?

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A. Yes they can. Sometimes, even if your policy appears to cover a procedure, fine print can limit or even eliminate coverage under certain circumstances. For example, your plan may cover a crown at 50%, yet stipulate a one year waiting period for all major services, including crowns. In this case, your insurance will most likely deny payment, and you could end up paying out of pocket for the entire crown.

There are many other types of restrictions that can change your coverage or surprise you with unexpected costs, which is why we recommend carefully reading your insurance policy and contacting your insurance company with questions. If you have any doubt as to out-of-pocket cost, please contact us to send a pre-treatment estimate, which will give you a better idea as to what portion of the treatment cost will be covered.

Q. I’m on Medicaid. What information regarding dental coverage is available to me?

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A. Since we are not a Medicaid provider, our Medicaid patients choose to pay for their services in full. If you do pay with cash or check (debit cards excluded), a discount of 5% will be applied. We also take debit and credit cards. Payment is required on the day of service. To find a provider that does accept Medicaid, the best option is to call the customer service number on your card to ask for a list of in-network providers.