Frequently Asked Questions

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Are you accepting new patients?

Absolutely! All of our providers are currently accepting new patients. We absolutely love meeting new people and helping our existing patients’ friends and family. Please call us or email and will be happy to discuss your current dental needs and set up an appointment that is right for you.

Are you open 24 hours?

We aren’t a 24 hour office. We do have early morning, late evening, and weekend appointments available – even on holidays! This way we can fit New Yorkers’ busy schedules and accommodate dental emergencies. We do have an overnight answering service with access to the next day’s schedule. If you are having an emergency at night please call us at (212) 804-7488 and if there is a next-day appointment available, our answering service will be happy to reserve it for you. The answering service can also relay a message to us asking one of our scheduling coordinators to call you back in the morning to help.

Can I just walk in?

In order to ensure that all of our patients have the time and attention they deserve and don’t have to wait, we are unable to accommodate walk-ins. We do usually have a few same day appointments available, so don’t hesitate to call us and see if we can accommodate you.

Can I schedule an appointment online?

Yes, you are more than welcome to schedule your appointment through ZocDoc, or you can easily request an appointment directly with our office by clicking the link at the bottom of the page and one of our scheduling coordinators will be in touch.

Can I set up a payment plan with you to cover my treatment?

Certainly, we have many flexible options to suit your budget. Our financial coordinators are here at your convenience to discuss different financial options to help you manage the cost of care.

Do you have an in-office insurance plan available?

The Central Park West Dentistry Hygiene Membership is a convenient program that allows you to make manageable monthly payments toward your sustained oral health. Membership is based on an open enrollment, so you can sign up today, or in a week, or in a month! Your membership will be active immediately. Click here to get started, or call us at (212) 804-7494 and we can help you find the plan that is best for you.

Do you treat children?

Yes, we are happy to see children of all ages. Dr. Lhota and Dr. Kuller are especially wonderful with children, as are all of our hygienists.

How do I schedule an appointment with one of your specialists?

We’d be happy to schedule a consultation with any of our specialists to discuss your treatment goals or concerns.

What can I expect at my first visit?

Click here for more information.

What is your cancellation policy?

Our providers reserve each appointment just for you, and we don’t overbook. We request that you let us know 48 hours in advance if you’ll need to cancel or reschedule your appointment. In the event that you have to cancel your appointment short notice, a broken appointment fee of $75 per hour of time reserved is collected and donated to the charity of your choice (options include St Jude Children’s Research Hospital, Doctors Without Borders, and the ASPCA). Of course, we understand that life happens, and emergency circumstances do occur, but please notify us as soon as you know you are unable to make it so that we can offer the time reserved for you to another patient in need.

What should I bring to my appointment?

A photo ID, a dental insurance card if you have one, and a form of payment.

Can you send a pre-approval to my insurance company?

Certainly. This is the most accurate way to assess any out-of-pocket expenses you may incur, however it is still an estimate and subject to change at the plan’s discretion. Pre-approvals can take weeks or even months, so if the treatment is mandatory, we recommend allowing us to estimate your coverage and we can settle up after the insurance pays for your claim, rather than delay treatment that may get worse over time.

Do plans ever change?

Yes, plans can and do change. Even though you may have the same insurance, your employer may opt to change the level of coverage at any time, which could improve or reduce your covered benefits. It is very important that you let us know if your plan changes, or if you get a new insurance card, so that we can update our records.

I have more than one dental insurance plan. Can I use both?

Absolutely. However, even though you may have two dental benefit plans, there is no guarantee that both plans will pay for your services. Some secondary plans will not pay until you have exhausted the entire maximum of your primary coverage. In most cases, even if both plans pay, the payments from all insurers will not add up to more than the total charges.

Is it normal to have to pay out-of-pocket?

Yes. Unlike traditional insurance, dental benefits are not meant to cover all oral healthcare needs. The dental policy is simply a benefit to offset a portion of your cost of care. Your dental coverage is not based on what you need or what your dentist recommends. It is based on how much your employer pays into the plan. Our office will file claims and estimate your coverage for you, but if the insurance company declines to pay, any portion of the bill not covered by insurance is your responsibility. Luckily, our office provides some of the most flexible payment options around to help you manage any out-of-pocket expenses.

It looks like my insurance will cover 100% of a particular service. Is that an exact number?

Sometimes yes, sometimes no. Each employer chooses a plan with a certain list of allowable fees, known as a fee schedule. As you use your insurance, we get to learn your plan’s allowable fees. If an insurance indicates they cover a dental wellness visit at 100%, but their fee schedule allows up to $170 for a dental wellness visit then they will pay a total of $170 for the visit. Many times the insurance’s allowable fees are the same as our office fees. Sometimes they aren’t. If we bill your insurance for a dental wellness visit at $180, and they allow 100% of $170, you will be responsible for the remaining $10.

So, how do you calculate my copay?

We consider the most current information we have for your plan. If we have very little information available, we will estimate based on similar plans and utilize the breakdown of benefits provided by your insurance company which shows a range of common procedures and the percentages that they allow for each (100% for procedure A, 80% for procedure B, 50% for procedure C covered up to the annual maximum). The benefit information your insurance provides is by no means comprehensive and does not include their allowable fees for each procedure, so the more you and others with your plan use it, the more accurately we can estimate your out-of-pocket expenses. All copayments collected are an estimate; sometimes the insurance may pay more or less than we assess. If they pay more, we will let you know, and you can request a refund check. If they pay less than we estimate, we’ll send you a statement, and you will be responsible for the charges.

What are frequency limitations?

A dental plan may limit the number of times it will pay for a certain treatment. But some patients may need a treatment more often to maintain good oral health. For example, one plan may cover dental wellness or gum therapy visits twice a year, while another allows four times a year. If a patient needs a dental wellness or gum care visit four times a year, but their plan only covers cleanings or gum care twice a year, the other two would be out-of-pocket. It’s important to make treatment decisions based on what’s best for your health, not just by what is covered in your plan.

What is a deductible?

A deductible is an extra fee imposed by your insurance plan on certain types of services. If you have a deductible, you only have to pay it one time a year per patient on the plan.

What is a pre-existing condition?

A dental plan may not cover conditions that existed before you enrolled in the plan. For example, benefits will not be paid for replacing a tooth that was missing before the effective date of coverage. Even though your plan may not cover certain conditions, you may still need the treatment to keep your mouth healthy.

What is a waiting period?

A waiting period may be imposed if you have a new plan, for some or all dental services. This means you and your employer must pay premiums for a period of months (usually 6 to 12 months) before you can utilize your benefits.

What is an annual maximum?

Think of your annual maximum as an insurance bank account that renews every year. All services, unless otherwise stated, get deducted from the maximum. Once you have exhausted the bank account, any other services must be paid for out-of-pocket. Unused dollars do not roll over into the next year, unless your plan has a special rollover account. Each member on the plan has their own annual maximum account. Most plans have an annual maximum of $1,000 to $2,000 a year to offset out of pocket costs, however you are still expected to pay all copayments and deductibles that may apply.

What is the difference between a PPO and HMO/DMO insurance?

PPO stands for Preferred Provider Organization. HMO stands for Health Maintenance Organization. Our office works with all types of PPO insurances, which allow patients the freedom to choose providers regardless of their network affiliation. An HMO or DMO plan requires that you choose a dentist from an insurance participation list. Patients with PPO insurances can see a specialist without a referral, while patients with HMO’s must obtain a referral before seeing a specialist. HMO dentists receive a check each month based on the number of patients who are assigned to him or her and are expected to perform services for a deeply discounted rate or at no charge, while PPO dentists only receive money from the insurance company if services are rendered. Usually patients who have an HMO or DMO plan will notice their choices of dentists are very limited, and their access to quality care including elective and cosmetic services are compromised. However, their out of pocket costs are generally lower than PPO plans, and have fixed copayments. Having a PPO plan allows patients access to a larger number of dentists providing better quality care at a greater out-of-pocket cost.

What is the difference between in-network and out-of-network?

Our office is in-network with Delta Dental Premier, Cigna PPO, and Aetna PPO. We have signed a contract with these insurance companies so that any patients who come to see us with one of these plans, we will charge the insurance company a special rate, usually 10-20% off our normal office fees. With any other PPO plan we are considered out-of-network, which means we aren’t in a contract with the insurance company, but patients can still use their insurance here at our regular office fees. In many cases, patients have the same insurance maximums and percentages of coverage for both in and out-of-network. If you have any questions about your plan, we are happy to do a complimentary benefits check for you and let you know all about your coverage.

Who decides what’s covered under my plan?

Almost all dental plans are a contract between your employer and an insurance company. Your employer and the insurer agree on the amount your plan will pay and what procedures are covered. Usually, employers choose to cover some, but not all of employees’ dental costs. Often, you may have a dental need that is not covered by your plan. If you are not satisfied with the coverage provided by your insurance, be sure to let your employer know.

Why is my claim getting denied or only partially covered?

Sometimes, in order to control costs, insurance companies may reduce your benefits using the following methods:

  • bundling: two different procedures were performed on the same tooth, but the insurance company combines it into one procedure
  • downcoding: the dental plan changes the procedure code to a less complex or lower cost procedure than was actually performed (for example, a white filling was performed but they changed the code to a silver filling)
  • least expensive alternative treatment: if there is more than one way to treat a condition, the plan will pay only for the least expensive treatment. For example, your dentist recommended an implant, but the plan may only cover less costly dentures.
  • delaying payment: the insurance company may not pay your claim for many months, and ask for additional information multiple times
  • not medically necessary: the insurance company may deny payment stating that they did not receive enough proof of necessity. You can appeal this process with a letter from your dentist, including supporting photos and x-rays to explain the treatment decision.
Can I schedule an appointment just for a cleaning?

It’s best to get a checkup along with your cleaning so that a doctor can determine your oral health and check for mandatory restorative needs. Without an exam by a licensed dentist, a hygienist can’t diagnose potential problems like decay, infection, fracture, bone loss, and tumors. We strongly encourage our patients to come in for a complete dental wellness visit which includes a cleaning, exam, and sometimes x-rays.

How does whitening work and how effective is it?

Bleaching procedures can change your natural tooth color by removing both deep and surface stains. In-office (chairside) whitening and at-home (tray) whitening both rely on bleaching. A light-activated whitening session in a dentist’s office, sometimes called chairside bleaching, can result in instantly and often dramatically whiter teeth. However, after a year or so of eating and drinking normally (coffee, tea, soft drinks), your teeth become slightly discolored again and develop new stains. A custom made tray created by your dental hygienist, known as in-home bleaching is typically worn for several hours a day or overnight for two weeks. When you notice new staining, you can wear your trays again to take the stains off and achieve your desired shade. When in-office whitening is done at our office, we also make you complimentary custom made trays to allow for such touch-ups. Everyone responds differently to different whitening procedures, but be aware: clean teeth will always whiten better. Some people respond well to whitening procedures, while people with gray teeth or other severe discoloration may require porcelain veneers or bonding to achieve the goals desired. Your dentist and dental hygienist can determine what’s right for you.

How often should X-rays be taken?

At least once a year. The health of your mouth can change in a short amount of time, so we want to be able to catch problems while they’re small, to save you unnecessary expense.

How safe are dental X-rays? Do I have to get them?

We have digital x-ray machines that limit the radiation beam to the small area being x-rayed. Digital x-rays have 17 times less radiation than traditional film x-rays. We also have lead-lined aprons that protect the body from radiation. It’s important to have regular check-up x-rays to allow your dentist to detect disease and other conditions much sooner than by examination alone.

What are dental sealants, who should get them, and how long do they last?

Sealants are a thin coating painted on the chewing surfaces of teeth to prevent tooth decay. The painted on sealant quickly bonds into grooves of the teeth, forming a protective shield over the enamel. Dental sealants are beneficial for all ages! Ideally, children should have sealants done on their permanent molars and premolars as soon as they come in. However, adults without decay or fillings in their molars can also benefit from sealants.Typically, sealants can last up to 10 years, but they need to be checked for signs of wear at your dental check-ups. Your dental hygienist can replace sealants as necessary. Keep in mind that it is still possible for decay to get under a sealant that wears out, so it’s important to have regular x-rays taken to help your dentist examine these areas.

What should I use to clean my baby’s teeth?

Before your baby’s teeth come in, you can use a piece of gauze moistened with water to remove plaque from teeth and gums. Once your baby has several teeth, you could use a baby toothbrush with a small head and a tiny amount of toothpaste.

When should I take my child to the dentist for the first check-up?

In order to prevent dental problems, your child should see a dentist when the first tooth appears, or no later than his/her first birthday.

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