Insurance Information
Dr. Jackson is not contracted with any specific insurance plan. Therefore, payment is due at the time of your visit. As a courtesy, we will bill your insurance plan for you. Depending on the type of plan you have, you will be responsible for payment in full at the time of your visit and then you will be reimbursed directly by your plan (usually within two weeks,) or you may be responsible for your copay at the time of your visit and your insurance company will send reimbursement to us. Either way, we will do all we can to help with your insurance company and we will help resolve any issues that may come up. For more information, continue reading through our examples and FAQs below, and, as always, feel free to call us if you have any questions.
EXAMPLE 1 - Delta Dental:
We will bill Delta Dental for you and they will send a reimbursement check directly to you. You will pay us in full at the time of your visit. We will submit your claim to Delta that day and they will send you a reimbursement check directly within two weeks of your visit. If, in the rare instance, you do not receive your check from Delta, or there are questions about your reimbursement, call us and we will help assure that you are getting the proper benefit.
EXAMPLE 2 - Cigna, Aetna, Principle, MetLife... :
We will bill these companies for you and they will send a reimbursement check to us. Therefore, you will need to pay your estimated co-pay at the time of your visit. We will submit your claim to your insurance company that day. Sometimes the amount of your estimated copay might change. In these cases, we will bill you for any additional payment required, or we will send you a reimbursement check for any overpayment that might result.
INSURANCE FAQ
I have Delta Dental, when will they pay me?
Delta is required to send you your reimbursement payment within 14 days of receiving your claim. We will submit your claim electronically immediately following your child’s appointment. Usually, Delta sends a check within a week of your visit.
What if I don’t get my check?
Call us! We will be your advocate in working with them. If you have not received your payment within 21 days of the service date, we will contact them immediately and help troubleshoot the issue for you.
How much will my appointment cost?
We will provide you with an estimate of the amount due ahead of your child’s appointment. Payment can be made online, over the phone or in person on the date of the visit.
What if my insurance changes or I have two insurances?
No problem! Call us so we can update your insurance. If you have two plans, we will still bill both for you. Most insurance carriers (MetLife, Principle, Aetna, Cigna, Guardian, Ameritas, Humana, GEHA, AXA, Carington, Coastal TPA, etc.) will pay our office directly.
Other Questions?
We are here to help you navigate your insurance. We want to make it as easy as possible for you. Please call or email Stephanie with questions or concerns. 831-662-2900 or santacruzkidsdentist.stephanie@gmail.com.
From our official office policy:
- For patients with insurance:
a. Co-payments and deductibles are due at the time of service.
b. Any unanticipated amounts, not paid by your insurance company, are your responsibility.
c. After (60) days, all outstanding balances, including outstanding insurance claims, are due and payable by you.
d. As a courtesy to you, we will handle the insurance billing; however, it is not our obligation.
e. If your insurance company requests information from you, you must respond in a timely manner.
f. We recommend that you keep track of your benefits (such as maximums or eligibility requirements).
g. It is your responsibility to make sure your insurance is paying what they are supposed to. We will assist you as needed.
h. All recommended treatment is determined to be necessary for the oral health of your child. Failure of your insurance company to pay does not indicate the treatment can wait nor waive any of our fees.