Some insurance companies will pay a portion of the orthodontic fee. Since there are countless agreements between insurance companies and patients, it is impossible for our office to keep track of all policies. Because of this variance, it is our office policy to have insurance benefits sent directly to our patients.

In most cases orthodontic insurance benefits pay a portion of the total fee up to the lifetime maximum allowed by your policy. The lifetime maximum is released in installments, designated by your particular insurance policy, over the course of treatment. The installments are sent directly to you. Most insurance companies do not require monthly submissions after the initial claim has been processed. During your treatment we ask that you stay current with payment to our office as agreed in your contract, regardless of when you receive checks from your insurance company

Our office will send you an insurance claim form when the appliance placement appointments have been scheduled with our office. The form will include directions for completion and submission to your insurance company. The information needed by the insurance company in order to reimburse you is contained in the form.

If you have any questions about your account with us, please feel free to contact our office at 610-374-4097. If you have specific questions about your orthodontic insurance benefits, please call your insurance carrier or your employer’s benefit office.

Answers to these questions will be helpful:

  • What is your lifetime maximum for orthodontic treatment? What percentage of each payment does your insurance company reimburse you?

    Most companies pay 50% of each payment until the lifetime maximum has been reached

  • How are the insurance payments released?

    Monthly or quarterly.

  • Will you need pre-authorization from your insurance company before our office can begin treatment? Adult orthodontics?

    Some policies only cover orthodontics for patients up to the age of 19.

Please feel free to discuss any area of your dental insurance coverage with us. We are here to help you in any way we can.

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1268 Penn Avenue Wyomissing, PA 19610 Tel: 610.374.4097   Fax: 610.372.8119   Email: braces@fantasticsmiles.com