Billing & Finance

Payment Options

We Believe that Exceptional Dental Care is a Great Investment in Your Health. We Want to Make Your Experience Wonderful.

This is why we have a dedicated professional business office staff of five that are happy to work with you regarding your insurance for dental work and all your dental financials needs. We offer several payment options and payment plans for dental work.

We will explain all dental procedures and associated fees clearly and professionally before we begin treatment. It is our policy to make definite financial arrangements with patients before any treatment begins.

Payment Options

Insurance Providers

Medical and dental insurance can be confusing. The friendly staff at Madison Family Dental Associates is happy to answer your questions and help you get the most from your insurance.

We are in-network providers for Physicians Plus, Delta Dental, American Dental Plan, Humana, WEA, Momentum Dental Plan, and Ameritas. As a service to you, we also file insurance for most other dental plans. Your payment, or copay, is required at the time of service. If you do not have insurance, we offer a 5% discount if payment is made with cash or check at the time of service.

Other Payment Methods

For your convenience, we accept Master Card, Visa, American Express, and Discover Card. We also offer a third-party financing option. To meet your financial needs, our business office representatives are available in person or by phone to discuss financial arrangements with you. We now offer an online bill pay option.

Financing Available

Madison Family Dental Associates is pleased to work in conjunction with Wells Fargo in providing you with financing for your dental services. The Wells Fargo Health Advantage® credit card* offers two options that allow you to finance for a period of 6 or 12 months.

*The Wells Fargo Health Advantage® credit card is issued with approved credit by Wells Fargo Financial National Bank. Ask for details. Apply online and see if you qualify today!

Commonly Asked Questions About Insurance, Billing and Finance

How does Madison Family Dental Associates file claims?

On the same day you receive services, your charges are entered. The next day a claim is generated. We file most of our claims electronically unless an insurance carrier cannot receive electronic claims. This is done through a secure website to protect your privacy. If you are having major restorative procedures, your insurance company may require an x-ray, detailed information on why the procedure was done, or periodontal charting. We may also need additional information from you about previous dates that work was done on your teeth or how long a tooth has been missing.

Why was my insurance claim denied?

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

Your name or the patient’s name is misspelled
The patient’s birth date is wrong
Your Subscriber Number or Group Number is wrong
The Student Status has not been updated with your insurance company
You did not see a provider within your network
Insurance has terminated
You have reached your benefit maximum for the year
Your insurance company only allows cleanings every six months or two times per year
Not a covered benefit
You have a waiting period for Major Restoration procedures
There is a missing tooth clause

What do I do if my insurance changes?

Even the simplest change can prevent your insurance claim from being processed correctly. You may still have the same insurance company but did the Group Number or Plan Number change? Did the Subscriber Number change? To prevent this situation, please be prepared to verify your insurance at every visit.

Did you have an accident?

If you or a family member is being seen as the result of an accident, we will need your medical insurance. Your medical insurance is primary in these situations and needs to be filed prior to your dental insurance. Filing claims in this order will prevent most delays in the claim being paid.

What is not an accident according to my insurance company?

Your insurance company generally does not define biting on something hard and chipping or breaking your tooth as an accident.

What should I do if I or a family member has had an accident?

Contact your dentist within 24 to 48 hours of the accident
Contact your medical and dental insurance companies within 24 to 48 hours of the accident
Be seen within 24 to 48 hours of the accident – most insurance companies require this
Give your medical insurance to the staff at the clinic at the time of your appointment

Can insurance companies limit coverage?

Yes they can. It is best to contact your medical insurance company immediately to get directions from them as to what needs to be done for benefits to be received.

What happens if procedures cannot be performed to restore the tooth within a short period of time (less than six months)?

Contact your insurance company to see if there are any limitations. In most cases, if an exam was performed within 24 to 48 hours with documentation as to why restorative care cannot be completed at this time, this is sufficient.Please contact your medical and dental insurance if you have any questions.

How do I coordinate benefits between medical and dental insurance?

We will file all claims for the accident to your medical insurance first. If the medical insurance denies or only pays a portion we will coordinate benefits with your dental insurance. Please inform the staff of any follow-up care that needs to be filed under the accident claim.

How does Madison Family Dental Associates preauthorize services?

At the patient’s request, we will send information to an insurance company for major services that have been recommended. This is done so the patient will know in advance if the services to be performed are covered under their insurance plan and the estimated cost of treatment for the patient. This can also help patients plan for services that they would prefer to have done in the next benefit year.

How accurate is a preauthorization?

Your insurance company does not guarantee they will pay this amount and it is only an estimate of benefits.Having services prior to the preauthorized work performed may use your remaining benefits or reduce the amount available.

For example:

You will be having a crown done that costs $1000
You have a maximum benefit of $1000 for the year
You have used $400 in benefits already this year and have $600 remaining
Your estimate of benefits for the crown is $475 ($50 deductible and 50% coverage)
The estimate is that the insurance will pay $475 and you will pay $525 for the crown
Before you have the crown done, you will come in and have four fillings, which uses $300 of your benefits
You have the crown done and the insurance pays $300. Why?
Maximum Benefit $1,000
Used Benefits $400
Filling Benefits $300
Available Benefits $300
Total Benefits Used $1,000

You exceeded your benefits so $175 of the estimate will now be part of the patient-responsible balance. The insurance will pay $300 and you will pay $700.

Please ask your dental provider to preauthorize any future, major restorative services if you have a concern for your patient responsible balance.

What is considered major restorative care?

Can I have other services preauthorized?

Yes. We recommend that multiple fillings, extractions, or sealants be preauthorized if you have a concern regarding benefits. Please ask us to preauthorize these services, as this is not done without the request of the patient or parent.

How do you make my dentistry more affordable? Do you offer payment plans?

We watch that our fees are consistent with the level of care, skill, and judgment your case requires and are in-line with fees in our area. We want our patients to secure their dentistry without worrying about the financial part. We accept Visa, Discover, MasterCard, American Express, debit cards, cash, and personal checks. We also offer special financing with approved credit through Wells Fargo Financial National Bank. If you have no insurance, we offer a 5% discount with cash or check payments on the day of service. We would be happy to answer any financial or insurance questions you have.

Do you offer any financing options?

Madison Family Dental Associates is pleased to work in conjunction with Wells Fargo Financial National Bank to provide you with financing for your dental services. Wells Fargo Health Advantage offers a few financing options which allow you to finance on purchases of $400 or more for a period of 6 or 12 months. Apply online and see if you qualify today!