Insurance

We are committed to providing you with the best possible affordable care. If you have medical/dental insurance, it is our goal to help you receive your maximum allowable benefits. In order to achieve these goals, we need your assistance and your understanding of our payment policy. Our staff deals with many insurance companies. Most companies offer multiple plans. Because many companies frequently change policies, it is difficult to accurately estimate our patient’s insurance co-payment. Most insurance companies will not give out fees until after the treatment is completed. Please keep us informed of any change to your insurance. It is important that all information about you is current.

Co-Payment:

All co-payments are payable when you check in at the front desk.

HMO Patients:

If a patient comes to us with a problem that they expect to be covered by medical insurance, (biopsies, trauma, tumors, infections, deformities) they must have a referral from their primary care physician. A referral from a dentist is not adequate for medical insurance coverage. Obtaining a medical referral is the patient’s responsibility. We cannot obtain the referral for you, and the referral cannot be obtained retroactively. If you do not have a referral, we will be happy to see you on a cash basis, but your medical insurance company will not pay for your treatment.

Medicare Patients:

Medicare pays us directly for your care. You are responsible for any deductible and co-insurance. If Medicare denies your procedure, you are responsible for the charges.

Private and Group Insurance: As a courtesy, we will file your insurance claims for you. Upon receipt of an insurance payment, any balance due will be billed to you. If you have deposited an excessive co-payment, it will be refunded to you.

If you have any problems or questions, please ask our staff. They are well informed and up-to-date. Please call if you have any questions or concerns regarding your initial visit.

As a courtesy Dr. Punjabi‘s staff will file a claim form to your insurance, but you are financially responsible for the services rendered for yourself, or your dependents regardless of your insurance. Payment for services is due before services are rendered unless payment arrangements have been approved in advance by our staff. We accept cash, checks, MasterCard, Visa and a payment plan with approved financing companies. Upon credit approval for the finance plan, you can charge the fees for your treatment immediately.

We will gladly discuss your proposed treatment and answer any questions relating to your insurance as best as we can. You must realize, however, that:

• Your insurance is a contract between you, your employer and the insurance company. We are not a party to that contract.
• Our fees are generally considered to fall within the acceptable range by most companies, and therefore are covered up to the maximum allowance determined by each carrier. This applies only to companies that pay a percentage (such as 50% or 80%) of “U.C.R.”. “U.C.R.” is defined as usual, customary, and reasonable. However, many insurance companies arbitrarily set their own negotiated fees as U.C.R. that we are not privy to and it is impossible to estimate your share of payment, till after the insurance company pays the claim. In such cases we will request a deposit be paid prior to the treatment.
• Not all services are a covered benefit in all contracts. Some insurance companies arbitrarily select certain services they will not cover.

We must emphasize that, as health care providers, our relationship is with you, not your insurance company. While the filing of insurance claims is a courtesy that we extend to our patients, all charges are your responsibility from the date the services are rendered. We realize that temporary financial problems may affect timely payment of your account. If such problems do arise, we encourage you to contact us promptly for assistance in the management of your account.

If you have any questions about the above information or any uncertainty regarding your insurance coverage, PLEASE don’t hesitate to ask us. We are here to help you.