{"id":968,"date":"2012-02-28T04:37:40","date_gmt":"2012-02-28T04:37:40","guid":{"rendered":"https:\/\/iowamercuryfreedentistry.com\/?page_id=968"},"modified":"2023-07-07T21:05:56","modified_gmt":"2023-07-07T21:05:56","slug":"insurance-fees","status":"publish","type":"page","link":"https:\/\/iowamercuryfreedentistry.com\/?page_id=968","title":{"rendered":"Fees \/ Insurance"},"content":{"rendered":"

What are the initial fees?<\/strong><\/p>\n

We are a family practice and indeed we do see children. \u00a0We are currently scheduling appointments for\u00a0\u00a0new patients.<\/p>\n

Our initial exam fee for adults is $399.00 and for children is $150.00. \u00a0The adult exam is extremely comprehensive and typically lasts at least two hours or longer and includes a consultation. \u00a0Both the adult and child exams include digital photographs, at no extra charge,\u00a0\u00a0in addition to x-rays. \u00a0This allows you to see everything we see and makes your participation in \u00a0treatment planning much easier. \u00a0We have been told this is an incredible value and provides an invaluable opportunity for patients to understand their dental condition.<\/p>\n

These charges do not include “routine cleanings” which for adults are an additional $ 120 and for children are an additional \u00a0$ 94. \u00a0It is important to remember that, statistically, \u00a0 \u00a080 % of adults have some level of periodontal \/ gum disease. \u00a0If this is the case, you will be informed of that and the fact that a “routine recall cleaning” will not address your circumstances. \u00a0You will be provided a treatment plan to address this condition (which has systemic consequences) which will estimate the number of visits projected to be required and the cost. \u00a0Under those circumstances, you would not receive a “routine cleaning” at this visit.<\/p>\n

If x-rays are needed (typically every 3 to 5 years for a complete series on all your teeth, and every year for limited bite-wings to detect decay), there is an additional charge. \u00a0 \u00a0The complete \u00a0and comprehensive x-ray series cost is $ 170. \u00a0The more limited “annual” x-rays for children or adults \u00a0is typically between $ 56.00 and $80 .00 \u00a0 The need to take x-rays, as well as the cost, \u00a0can vary depending on the individual circumstances.<\/p>\n

We utilize digital x-rays which expose patients to minimal radiation. \u00a0These x-rays can be sent via e-mail to others who may have a need to see them. \u00a0If you have current x-rays at another office, and if they are digital, taken on computer sensors, you can request to have them e-mailed to us. \u00a0 If they are \u00a0the [“older”] film based x-rays, duplicate copies can be made and forwarded or they may be given to you to transport. \u00a0Typically, you will be asked to provide a written authorization to transfer the x-rays. \u00a0Generally, this can be done via e-mail or fax, sometimes by phone, as opposed to physically signing for them, however, this may vary depending on an office’s policies. \u00a0You should anticipate an office to assist you in\u00a0acquiring\u00a0your x-rays professionally and in a timely manner.<\/p>\n

Occasionally, an office may not have the capability to transfer or copy the x-rays and instead may \u00a0make paper copies. \u00a0These often may have lower quality\u00a0diagnostic\u00a0value and it is in your interest to request the digital transfer or film based copies.<\/p>\n

How much does it cost to have a mercury \u00a0amalgam\u00a0filling replaced?<\/strong><\/p>\n

Tooth colored posterior composite non-metal fillings range in price from $ 274 to $ 606 depending on size. \u00a0If a tooth has extensive decay or is cracked from the amalgam filling and \/or heavy biting forces, a porcelain \/ ceramic onlay may be recommended to increase durability. \u00a0You may still choose to have another composite filling placed, even if the porcelain is recommended. \u00a0 While the porcelain \/ ceramic onlay (or crown) \u00a0may be expected to last much longer than a composite \u00a0filling, you may still get a number of years of service from the composite filling. \u00a0If you choose to have a composite filling placed now (even though an onlay may be recommended) and in the [near] future if it should break and there be no alternative than the porcelain filling, \u00a0you will incur the initial charge for the composite filling now and, later, the charge for the onlay, essentially, paying for both, as opposed to paying for just the porcelain onlay if it is done initially.<\/p>\n

However, some patients who may want their amalgam fillings replaced timely, may elect to have all the mercury amalgams replaced with composites in the short term. \u00a0Then they can \u00a0plan, over the next several years, to have the [new] composites replaced with any necessary porcelain restorations as their budget allows. \u00a0If they chose to both replace the existing fillings with porcelain \/ ceramic AND to maximize their insurance benefits, they might extend the process, and the exposure to the mercury fillings, \u00a0over a number of years.<\/p>\n

Insurance coverage.<\/strong><\/p>\n

Due to the additional technique sensitivity \/ difficulty in placement of composite fillings there is usually a higher fee charged than for mercury amalgam fillings. \u00a0Often, insurance companies reduce the fee charged for a posterior composite filling to that allowed for a mercury filling.<\/p>\n

For example, \u00a0a $ 325 \u00a0filling charge may be reduced to $ 240 (just a guess) and THEN the insurance company pays their percentage (whether 50 %, 70 % or 80 %,\u00a0depending\u00a0on your contract). \u00a0You then also, in addition to your co-payment, pay the amount above their allowed [reduced] amount for that procedure, in this example, $ 325 – $ 240 = \u00a0$ 85 ( plus your co-payment on the $ 240).<\/p>\n

Typically, insurance companies pay from $ 1000 to $ 1500 per calendar year, depending on your contract. \u00a0Let’s assume, for the sake of example, that your annual dental benefit is $ 1000. \u00a0Lets also assume that your carrier will not reduce the fee allowed for composites to the amalgam fee (although they almost always do). \u00a0 Then you could have \u00a0$ 1250 worth of dental fillings done and at 80 % benefit, your carrier would pay $ 1000 and you would pay $ 250.<\/p>\n

The above example does not, however, take into account exams, x-rays, and cleanings that you might also have. \u00a0These procedures are usually paid at 100 %. \u00a0 If in addition to fillings, you wish to have the typical \u00a0two exams, two cleanings, \u00a0and several x-rays in one calendar year you might incur a $ 300 charge. \u00a0This would then decrease from $ 1000 per year to \u00a0$ 700 per year the amount that remains to do fillings. \u00a0Additionally, this \u00a0 $ \u00a0700\u00a0would be used to pay 80 % of charges on fillings, in this example.<\/p>\n

Fillings that are not damaged or decayed may not be covered by insurance whether the choice to remove them is strictly for cosmetic reasons, \u00a0for mercury content or the desire to not have metal in the mouth. \u00a0These would be “out of pocket” expenses for an insured patient.<\/p>\n

What if I need an onlay ( or crown)?<\/strong><\/span><\/p>\n

If you have a very large filling or a cracked tooth, a porcelain onlay (or crown if the damage is very extensive) may be recommended. \u00a0This requires not only removal of the existing filling and decay, but\u00a0additional\u00a0shaping and preparation of the tooth. \u00a0This will provide room for the thickness of the porcelain that will be bonded over the top to protect and strengthen the tooth.<\/p>\n

You can expect to pay $ 1500 for the porcelain onlay or crown. \u00a0If you have insurance you can, generally, expect it to pay 50 %, 70 % , 80 %, more or less, or whatever the contract language specifies.<\/p>\n

The tooth is prepared for the onlay or crown at one appointment and an impression (model) is then made and a temporary onlay or crown is placed on your tooth. \u00a0 The model is sent to a dental lab to make your onlay or crown and you will be re-scheduled to return about two weeks later to cement the finished restoration.<\/p>\n","protected":false},"excerpt":{"rendered":"

What are the initial fees? We are a family practice and indeed we do see children. \u00a0We are currently scheduling appointments for\u00a0\u00a0new patients. Our initial exam fee for adults is $399.00 and for children is $150.00. \u00a0The adult exam is … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":292,"menu_order":2,"comment_status":"closed","ping_status":"open","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/iowamercuryfreedentistry.com\/index.php?rest_route=\/wp\/v2\/pages\/968"}],"collection":[{"href":"https:\/\/iowamercuryfreedentistry.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/iowamercuryfreedentistry.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/iowamercuryfreedentistry.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/iowamercuryfreedentistry.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=968"}],"version-history":[{"count":25,"href":"https:\/\/iowamercuryfreedentistry.com\/index.php?rest_route=\/wp\/v2\/pages\/968\/revisions"}],"predecessor-version":[{"id":1302,"href":"https:\/\/iowamercuryfreedentistry.com\/index.php?rest_route=\/wp\/v2\/pages\/968\/revisions\/1302"}],"up":[{"embeddable":true,"href":"https:\/\/iowamercuryfreedentistry.com\/index.php?rest_route=\/wp\/v2\/pages\/292"}],"wp:attachment":[{"href":"https:\/\/iowamercuryfreedentistry.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=968"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}