About our Fees

About our Fees

Our fees are set by the actual costs of doing business in this particular office. Obviously, costs can vary from office to office depending on the level of experience of the dentist, the quality of service, the amount of high tech equipment available, materials used, the quality of the lab used, and many other factors. We have never tried to be all things to all people, and by the same token, we have never tried to be the cheapest office. Our fees reflect the quality of service and the care with which it was delivered. We also want our patients to know that our sterilization standards are second to none and are well above what is required by the profession.

"Reasonable and Customary" What Does It Mean?

We are sometimes asked by our patients, “Why is your fee for this over what my insurance company calls ‘usual and customary’, does that mean I was overcharged?” That's a good question and one we're happy to answer.

Insurance companies on an individual basis come up with “usual and customary” fees for all dental procedures for a certain geographical region. When our state dental association asks these companies for data to see how the numbers were arrived at and who, if any, dentists were surveyed, they are told categorically by every insurance company that this is confidential, internal information and they will not reveal it.

Our answer is, “If this survey was done fairly, and truly represents the fees in a given area, then why can't we see how it was done?” The insurance industry seems to be incapable of understanding this type of logic. The fact is that different insurance companies have different reasonable and customary fees for the same area. If the calculations were done correctly and fairly, they should all have the same fees. They do not because the “calculations” were not done fairly and correctly. They supposedly survey a particular area, and then come up with an "average", which they then reduce by some set percentage. Included in this survey are discount dental clinics and mass production “managed care” facilities that bring down the average. Many times, these “surveys” are up to three years old.

The insurance company's main reason for establishing artificially low “reasonable and customary” fees is to limit the amount of benefits paid in an attempt to control costs for the employer. A sad by product of this practice is that it can cause animosity between the dentist and an “uninformed” patient. Any time an insurance company says they're on your side, you had better look out! Insurance premiums have increased every year while yearly maximum benefits are basically the same as they were back in 1971!

A dental plan is nothing more than a contract between the employer and the insurance company to partly pay for certain services. There are deductibles, some services are paid on a percentage while others may not be covered at all. Your employer buys a contract at a specified premium and includes as many or as few benefits as the employer is willing to pay for. It is a well known fact within the industry that a higher premium paid by the employer will get you, the patient, a higher “usual and customary” fee schedule.

If price is a patient’s only concern when choosing a dentist then our office may not be the right one for them. But if they’re looking for a higher level of quality, care, and concern, then we think they’ll find that we have what they’re looking for.

Excellence rarely comes under the dictates of “usual, or customary”.

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