Insurance and Billing

Insurance Information

At Marshall Oral, Facial & Implant Surgery Center we make every effort to provide you with the finest care and the most convenient financial options. To accomplish this we work hand-in-hand with you to maximize your insurance reimbursement for covered procedures or provide payment option plans.

Any questions you may have regarding insurance coverage would be best and most accurately answered by directing them to your insurance company. They will be able to answer any eligibility and coverage information. If you have any problems or questions, please ask our staff. They are well informed and up-to-date.

Please bring your insurance information with you to the consultation

to ensure that we can expedite reimbursement.

DENTAL INSURANCE

Marshall Oral, Facial & Implant Surgery Center is a provider for Anthem 100/200/300, Delta Dental Premier, Metlife Dental, Guarian and Dentemax. Any other insurance plan will be considered out-of-network. Other than wisdom teeth extractions, most all extractions are considered dental. Dental implants are also considered under your dental plan. Payment for dental implants is due on the day of surgery, your dental insurance will be submitted for possible reimbursement. Any outstanding balances after insurance pays is your responsibility.

Pre-estimates and/or pre-determinations are done by request only. Generally, there is a 4 – 6 week response time from insurance companies on pre-estimates/pre-determinations. If your insurance company requires a pre-authorization or referral from your Primary Care Physician, it is your responsibility to bring the proper documents. Our office does not make any calls to your insurance company to verify benefits or to check the status on payment. If you have any questions regarding your coverage and /or benefits, you must contact your insurance company.

MEDICAL INSURANCE

Marshall Oral, Facial & Implant Surgery Center is an out-of-network provider for all medical insurance carriers. Oral & Maxillofacial surgery requires cross coding and/or billing between medical and dental. Wisdom teeth, Orthognathic Surgery and bone grafting can all be billed under your medical plan however, there is no guarantee of payment.

INSURANCE PAYMENTS

Insurance policies are contacts between you and your insurance company for reimbursement of your medical/surgical care. As a courtesy to you our office will bill your insurance company for x-rays and procedures. If your insurance company does not remit within 60 days, the balance of your account will be due in full. It is your responsibility to contact your insurance company or employer to establish why they have not paid on your account. Our office does not make telephone calls to insurance companies. However we will be happy to assist you with additional information that your insurace carrier may require for payment.

Your insurance company pays for your medical care based on what they refer to as usual and customary rates (UCR’s). These rates are what your insurance company decides they wish to pay for x-rays and procedures. Rates of payment will vary from one company to another. The rate your insurance company chooses to pay for services does not accurately reflect what or how our office charges for x-rays and /or procedures based on expertise involved in surgical and/or medical management of Oral & Maxillofacial Surgical conditions or trauma and the cost of medical supplies and overhead. 

Financial Information

OFFICE VISITS

Office visits are to be paid for at the time of your visit. If a valid insurance card is presented at the time of your visit, a down payment will be required. Please be advised that this does not reflect estimated insurance payments. Down payments are not calculated based on your insurance plan. You may still have an account balance after the down payment and insurance payment, which is due upon receipt.

PAYMENT OPTIONS

1. Cash – includes money orders and personal checks

2. Credit Card – we accept all major credit cards, Visa, MasterCard, Discover and American Express

3. CareCredit – offers a separate line of credit to cover your entire family’s health care needs.

We would be happy to work with you to plan the most appropriate arrangements for your budget. Financing your treatment will allow you to begin your treatment immediately and spread the cost over a period of time.

We deliver the finest care at the most reasonable cost to our patients, therefore payment is due at the time service is rendered unless other arrangements have been made in advance. If you have questions regarding your account, please contact us at (330) 670-0050. Many times, a simple telephone call will clear up any misunderstandings.

Please remember you are fully responsible for all fees charged by this office regardless of your insurance coverage.

We will send you a monthly statement. Most insurance companies will respond within four to six weeks. Please call our office if your statement does not reflect your insurance payment within that time frame. Any remaining balance after your insurance has paid is your responsibility. Your prompt remittance is appreciated. We can make arrangements for a monthly payment plan, but that must be implemented prior to the actual procedure.

LEGAL ARRANGEMENTS

Parents bringing their children to our office for treatment are responsible for payment in full regardless of legal arrangement such as divorce, separations, and legal involvement in accidents. Our office does not wish to make payments a hardship for anyone be we cannot become involved in legal arrangements.