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Dental Emergencies
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Dental Wellness & Treatment
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It’s best to get a checkup along with your cleaning so that a dentist 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. Central Park West Dentistry schedules complete dental wellness visits which includes a cleaning, exam, and any necessary x-rays.
Insurance, Pricing, & Financing
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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.
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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.
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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.
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The amount you pay for covered dental care before your insurance plan starts to pay. For example, if you have a $50 deductible, you’ll pay the first $50 of covered services yourself before your insurance kicks in to help. If you have a deductible, you only have to pay it one time a year per patient on the plan. Many insurance plans waive the deductible for preventative and diagnostic care like cleanings and exams, so it only applies if you need treatment like a filling.
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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.
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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.
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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) 579-8885 and we can help you find the plan that is best for you.
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We have many flexible options to suit your budget including pay-over-time with our partner Sunbit. Our financial coordinators are here at your convenience to discuss different financial options to help you manage the cost of care.
Our practice
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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.