NORTHWEST ENDODONTICS
SCOTT PACE DDS
Financing/Insurance
Insurance
At Northwest Endodontics we make it our top priority to provide you with the finest care and the most convenient financial options. To accomplish this we work hand-in-hand with you to maximize your insurance reimbursement for covered procedures. If you have any problems or questions, please ask our staff. They are well informed and up-to-date.
As dental treatment providers, we will gladly accept your estimated portion of the treatment fee and bill your dental insurance. There are many factors involved in estimating your insurance reimbursement accurately (see below). Please keep in mind, however, insurance companies routinely indicate that coverage verification does not guarantee payment. In the unlikely event your insurance does not pay the estimated amount, you will be responsible for the remaining balance.
INSURANCES WE ARE IN NETWORK WITH:
***Our office verifies we are in network with your specific insurance contract
Aegis
Aetna
Aetna Dental Medicare Advantage
Aetna Life Insurance Company
Aetna Maximum care (senior Supplemental)
Aetna Medicare Advange Plan
Aflac PPO Dental
All Savers Insurance Company
Alternative Ins Resources
Altus Dental, Inc
AlwaysCare
AmeriBen Solutions
Amerihealth Medicare Advantage
AmeriHealth New Jersey
Ameritas Life Insurance Corp
Anthem Blue Cross Blue Shield
Arm LTD
Beam Dental
Bento Cambalt Solutions, Inc
Best Health Plans
Best Life and Health Insurance Co
Beta Health Association
Black Hawk (Precise)(Virtue)(Luminous)
Blue Cross Blue Shield MN, AL, IL, MO, NM, OK, TX
Blue Cross Blue Shield Medicare Advantage MN, NM, TX,
IL, MI, IL, MT, OK
Blue Cross Blue Shield of Michigan (Care PPO only)
Blue KC Medicare Advantage
Blue Shield of CA
Boulder Admin Svcs
Bricklayers Local Union 15 Welfare Fund
Bricklayers SW Missouri
Bright Benefits
Capital BlueCross
CareFirst Blue Cross Blue Shield
Carington
Cement Masons & Plsters Local 518 Welfare Fund
Century Healthcare
Chesterfield Resources
Cigna DPPO, DVH
City of Pasco
Colonial Life
Commonwealth Care Alliance Medicare Advantage
Commonwealth Care Alliance Medicare Maximum (HMO D-SNP)
Commonwealth Care Alliance Medicare Preferred (PPO)
Commonwealth Care Alliance Medicare Value (PPO)
Community Care of Oklahoma Medicare Advantage
CompBenefits Insurance Company
Construction Industry Laborers
Coordinated Benefits
CoreSource
Covenant Administrators, LLC
Cypress Benefit Admin
Cypress Dental Administrators
Cypress Dental Insurance Company of California
DD Services, Inc
Delta Dental– ALL STATES
Delta Health Systems
Dental Health Options
Dental Select (Care PPO only)
Dental Works (workers comp)
DentaQuest-DenteMax Plus
DenteMax
Direct Care Admin
Direct Dental Administrators LLC
District Council #3 Painters & Allied Trades Welfare Fund
DNOA-Dearborn National, LineCo, BCBS TX, IL, NM, OK, MT, KS City
Dominion Medicare Advantage
EBSO, Inc
Emblem Health/GHI
EMI Health (Care PPO only)
Empire
Employee Painters Trust Health and Welfare
Encore Dental/Stonebridge Life
Equian LLC
Equitable Financial Life Insurance Company
Equitatable
Fallon Health
FCE Benefit Administrators, Inc
FEDVIP
Fidelio
First Dental Health, Inc
First Priority Health
First Priority Life Insurance Company (United Concordia)
First Reliance Standard Life Insurance of NY
Formula Corporation
Foundation for Medical Care (Health Edge)
Free Market Administrators
Freedom Life
GEHA
Global Health
Global Management
Group Administrators
Group Benefit Services
Group Resources
Guardian
Harrington/Colonial Life
Health Markets
Health Resources/Dental Health Options (care PPO only)
Healthcare Admin
HealthComp, inc
Healthgram
HealthNet Associates-HealthNet of AZ, CA, OR
Healthplex
Highmark BCBSD Inc. (United Concordia)
Highmark Benefits Group Inc (United Concordia)
Highmark Choice Company (United Concordia)
Highmark Coverage Advantage Inc. (United Concordia)
Highmark Delaware
Highmark Inc (United Concordia)
Highmark Select Resources Inc. (United Concordia)
Highmark West Virginia
HM Health Insurance Company (United Concordia)
HMO of Northeastern Pennsylvania (United Concordia)
HMO of Northestern Pennsylvania, inc
Humana (Zelis)
Humana Dental Access Discount Card
Humana Dental Central States Funds
Humana Dental PPO
Humana Dental Traditional Preferred
Humana Fed Advantage EPO FEDVIP AL, AZ, CA,CO, UT
Humana Federal Advantage PPO FEDVIP OH, AL, AZ, AR, CA, CO, FL, GA, IL, IN, KS, KY, LA, MD,MS, MO, NC,OK, SC, TN, TX, UT, VA, WV
Humana FEDVIP
Humana Health Benefit Plan of Louisiana, Inc
Humana Insurance Company
Humana Insurance Company of New York
Humana Nationwide
Humana One
Humana Dental Insurance Company
Imperial
Independence Blue Cross
Independence Blue Cross Medicare Advantage
Intergrity Administrators
Kaiser
Kansas City Life Insurance Company
Key Benefit Admistrators
Kuwait Cultural Office (KCO)
Level Inc. (Level Benefits Inc dba Level)
Lifemap
Lincoln Financial (DBP)
Lincoln Financial Insurance Company
Local 786 Building Material Welfare Fund
MAMSI Life and Health Insurance Company
Management Benefit Fund (ASO)
Manhattan Life
Merchants Benefit Administrators
Meritain Health, Inc.
Metlife FED VIP, PDP Plus
Mid-American Benefits, Inc.
Momentum Insurance Plans, Inc
Morgan White- Standard Life/Am First
Mutual of Omaha Life Insurance
National Care Dental-MBA
National Foundation Life (Care PPO only)
National General Accident and Health
National Rural Electric Cooperation Association Group Benefits
Nationwide Insurance
Neighborhood Health Partnership, Inc
New Era Life (NEL)- Philadephia American
Optimum Choice, Inc
Oxford Health Insurance, Inc.
Paramount Dental
Paramount Dental Medicare Advantage Plans
Paramount Promedics Medicare Advantage Plan
Passive- PPO
Peoples Benefit Life Insurance Company
Pequot Plus Health Benefit Services
Physiscians Mutual (under Ameritas)
Planstin Administrative Solutions
PrefererredOne Administrative Services, Inc.
Preferred Benefit Admin
Preferred Health Professionals
Preferred Insurance Specialist
Printing Specialties/ Northwest
Pro Benefits Admin/Dental Pay
Reliance Standard Life
Renaissance
Rocky Mountain Health Maintenance Organization Inc.
Roofers Union Welfare Trust Fund
Select Resources Inc.
Self Insured Services Co
Shelterpoint Pro Benefits Admin
SISCO
SkyGen
Solstice Benefits, Inc.
Staff Benefits Management & Administrators
Standard Ins Co
Standard Ins Co of NY
Starmount
Suffolk County Employee Benefit Plan
Sun Life Assurance Company of Canada
Sunlife Financial
Superior Dental Care
The Benefit Group Inc
The Dental Concern, Inc
Trans America
TransWestern Insurance Administrators
TRICARE (Retirees)
TriStar Benefit Administrators
TruAssure
Tuckpointers Local 52
Tufts Health Plan
UHC Optum Dental
UMR, Inc (a subsidiary of UnitedHealthCare
Union Security Insurance Company
Union Security Life Insurance Company of New York
United Claims Solutions
United Concordia (Care PPO only)
United Concordia Companies, Inc
United Concordia Dental Corporation of Alabama
United Concordia Inc
United Concordia Insurance Company
United Concordia Insurance Company of New York
United Concordia Insurance Company of the River Valley
United Concordia Life and Health Insurance Company
United Furniture Workers Insurance Fund (Variopro)
United Medical Resources
United of Omaha Life Insurance Company
UnitedHealthCare of WA, AL, AZ, AR, CA, CO, FL, GA, IL, KT, MS,
NY,NC,OK, OH, PA, SC, TX, UT, WI,
Unum
Vault Health Captive LLC
WellCare
WellCare by Allwell
Zelis Cigna
United Healthcare Medicare Advantage
UnitedHealthcare GEHA Group Medicare (PPO)
UnitedHealthcare Medicare Complete Assure (PPO)
UnitedHealthcare Dual Complete
UnitedHealthcare Medicare Silver (Regional PPO SNP)
Understanding Your Insurance
A dental insurance plan is a contract between you and an insurance company to pay a portion of your endodontic treatment. These contracts vary widely between different insurance companies. A typical percentage of the amount covered runs somewhere between 20% to 80% of the price charged by your endodontist. If your dental insurance is provided by your employer, then your employer has negotiated your benefits with your insurance carrier.
UCR (Usual, Customary and Reasonable)
Insurance companies use the term "UCR" to describe what they will pay for a particular endodontic treatment. These fees are generally 20%-80% less than what the endodontist charges for a particular treatment. Therefore; on your bill you will see a note that the fee charged by the endodontist is higher than the reimbursement from your insurance company. There is no regulation on how your insurance company determines these reimbursement levels. Some factors that influence the UCR fee are such things as number of endodontist in the region and cost of living.
Annual Maximums
Your plan purchaser makes the final decision on "maximum levels" of reimbursement through the contract with the insurance company. Your annual maximum may be unknowingly exceeded or nearly exceeded when we provide an estimate of your endodontic treatment.
Our Bottom Line on Insurance
We will assist you to the best of our ability in obtaining the maximum benefits from your insurance. We will only recommend treatment according to what is best for you, not according to your insurance benefits.
If you have any problems or questions, please ask our staff. They are well informed and up-to-date.
