At Heart of the Brazos Oral & Facial Surgery, we make every effort to provide you with the finest surgical 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. Additionally, if your insurance company requires that our services are pre-authorized, we will work with you to obtain such authorization in advance. However, as the insured member, you are ultimately responsible for ensuring that, prior to each visit, you have the required authorizations from your insurance carrier on file with our office.
We are participating providers for the following medical and dental insurance plans:
Delta Dental
Metlife Dental
Guardian Dental
GEHA
Scott & White Medical
Connection Dental
Tri-Dental Discount Plan
QCD Discount Plan
Careington Discount Plan
First Care Medical
Aetna Medical
Insurance contracts are subject to change. Please verify with our office or your insurance carrier.
As a courtesy to our patients, our office files all insurance claims for our patients and will assist you in obtaining your maximum level of benefits from your insurance company. As most of the services we provide in our office are deemed both medical and dental by many insurance companies, it is important that you provide our office with detailed information regarding all insurance policies in place prior to the time services are rendered.
Once insurance has processed your claim(s), you will receive a statement for any balance still due or a refund check for overpayment. Most insurance companies will respond to our request for payment within four to six weeks. As the insured member, you may be asked to assist us in obtaining payment from your insurance company if no response has been received within 30 days. In addition, after 45 days of filing your claim, if the insurance company has not issued payment for your claim, the balance on your account will become solely your responsibility. We kindly ask that you remit additional payments promptly.
TMJ and Orthognathic patients, you (the patient/insured member) are required to:
1.
Know whether or not your medical insurance requires a referral to a specialist (Dr. Clark and Dr. Warren are Oral and Maxillofacial Surgeons).
2.
Obtain that referral BEFORE you are scheduled to see Dr. Clark or Dr. Warren.
3.
Take time to call your insurance company to ask specifically about the doctor you wish to see and your covered benefits.
4.
Referrals typically have an expiration date and limited number of visits so you should carefully monitor the dates and number of visits.
HMO patients – If you expect your services to be covered by medical insurance (biopsies, tumors, TMJ infections, jaw deformities), you must have a referral from your primary care physician (“PCP”). A referral from a dentist is not adequate for medical insurance coverage. Obtaining a PCP referral is the patient’s responsibility. If you do not provide a referral, your insurance company will likely deny coverage and you will be responsible for payment of the charges.
