Office Policies

Appointments

We recognize that your time is valuable; therefore we make a concerted effort to begin appointments promptly; please arrive on time. Do understand that the nature of a pediatric office involves emergencies that can alter our schedule. We ask that you extend a courtesy to these families, just as you would expect, if it were your child being seen emergently. If you are unable to keep an appointment, please notify our office at least twenty-four (24) hours in advance so that we can offer the time to another child in need of treatment. Missed appointment fees are imposed only if you give us insufficient notice.

Ensuring the Privacy of our Patients

In our experience, children focus better without a parent present, thus fostering a more positive experience for your child; however, we will welcome a parent into the operatory. If you choose to accompany your child we ask you to respect the privacy of our other patients; we can only allow one parent with a child. If you plan to be with your child, please make arrangements for your other children as we cannot have unattended children in the reception area.

We ask that you silence your cellular phone and other mobile devices as a courtesy to our doctors, staff, and other patients. Any interruption would impact patient care and impinge on the privacy of others.

Financial Provisions and Insurance

To reduce billing costs and maintain reasonable fees, we require that you pay for treatment at the time of the visit. Please understand that under New Hampshire law, the parent who accompanies the child to the visit is responsible for payment of all charges. Legally, we cannot send statements to other persons. For your convenience we accept payment rendered by cash, check, Visa®, MasterCard®, American Express®, Discover®, CareCredit®, or PayPal™.

For more information on payment options please view our Payment Options Page.

Insurance

As a courtesy, we will be happy to accept assignment of benefits from your insurance carrier. When patients are scheduled for operative appointments (i.e. sealants, fillings, etc.) we request a minimum payment of 20% at the time of the visit, notwithstanding assignment of benefits.

If we have all of your insurance information on the day of the appointment, we will be happy to file your claim for you. You must be familiar with your insurance benefits, as we will collect from you the estimated amount insurance is not expected to pay.

You are responsible for any balance on your account after 30 days, whether insurance has paid or not. If you have not paid your balance within 60 days a finance charge of 1.5% will be added to your account each month until paid. Should it become necessary to send an account to a collection agency, we add a service charge to the balance.

PLEASE UNDERSTAND that we file dental insurance as a courtesy to our patients. We do not have a contract with your insurance company, only you do. We are not responsible for what benefits they pay on a claim. We can only assist you in estimating your portion of the cost of treatment; we do not guarantee what your insurance will do with each claim. We also can not be responsible for any errors in filing your claim. Our staff are happy to assist you with your insurance questions so please ask.

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General Facts about Dental Insurance

Fact 1 - NO INSURANCE PAYS 100% OF ALL PROCEDURES

Dental insurance is meant to be an aid in receiving dental care. Many patients think that their insurance pays 90%-100% of all dental fees. This is not true! Most plans only pay between 50%-80% of the average total fee. Some pay more, some pay less. The percentage paid is usually determined by how much you or your employer has paid for coverage or the type of contract your employer has set up with the insurance company.

Fact 2 - BENEFITS ARE NOT DETERMINED BY OUR OFFICE

You may have noticed that sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist's actual fee. Frequently, insurance companies state that the reimbursement was reduced because your dentist's fee has exceeded the usual, customary, or reasonable fee ("UCR") used by the company.

A statement such as this gives the impression that any fee greater than the amount paid by the insurance company is unreasonable or well above what most dentists in the area charge for a certain service. This can be very misleading and simply is not accurate.

Insurance companies set their own schedules and each company uses a different set of fees they consider allowable. These allowable fees may vary widely because each company collects fee information from claims it processes. The insurance company then takes this data and arbitrarily chooses a level they call the "allowable" UCR Fee. Frequently this data can be three to five years old and these "allowable" fees are set by the insurance company so they can make a net 20%-30% profit.

Unfortunately, insurance companies imply that your dentist is "overcharging" rather than say that they are "underpaying" or that their benefits are low. In general, the less expensive insurance policy will use a lower usual, customary, or reasonable (UCR) figure.

Fact 3 - DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED

When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume the fee for service is $150.00. Assuming that the insurance company allows $150.00 as its usual and customary (UCR) fee, we can figure out what benefits will be paid. First a deductible (paid by you), on average $50, is subtracted, leaving $100.00. If the plan pays 80% for this particular procedure, your insurance company will then pay 80% of $100.00, or $80.00. Out of a $150.00 fee they will pay an estimated $80.00 leaving a remaining portion of $70.00 (to be paid by you). Of course, if the UCR is less than $150.00 or your plan pays at 50%, then the insurance benefits will also be significantly less.

MOST IMPORTANTLY, please keep us informed of any insurance changes such as policy name, insurance company address, or a change of employment.

We look forward to meeting you and your child. Please ask questions or offer suggestions and we welcome and appreciate referrals to our office. At Amherst Pediatric Dental Associates we provide outstanding dental care in a caring, comfortable, and fun atmosphere. Your cooperation will help us educate, motivate, and excite your child about oral health. With our consistent preventive maintenance program and commitment to excellence, we can help maintain your child's beautiful smile.

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Call us today at (603) 673-1000 - We'll give your child a reason to smile!

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