Insurance Plans

Open Bright Pediatric Dentistry participates with following insurance companies:

Assurant PPO
Aetna PPO
Cigna PPO
Delta Dental PPO
Emblem/GHI PPO
Empire Blue Cross Blue Shield PPO
Guardian PPO
Metlife PPO
United Healthcare PPO
Dentaquest: Affinity, Fidelis, Healthfirst
Healthplex: Amerigroup, Emblem, Healthplus, HIP, Metroplus, Wellcare
United Healthcare Community Plan

All other open plan dental insurances are accepted on an out-of-network basis. If you choose to schedule with an out-of-network provider, you are responsible for all fees not covered by your insurance plan.

If we have received all of your insurance information on the day of the appointment, we will be happy to file your claim for you. You must be familiar with your insurance benefits, as we will collect from you the estimated amount insurance is not expected to pay. We file all insurance promptly, so your insurance company will receive each claim within days of the treatment. Your insurance processes the claim and sends you notice of the result (estimation of benefits, or “EOB”). Insurance will typically process claims within 30 days. You will be responsible for any deductibles, co-payments, or balances not covered by insurance. You are responsible for any balance on your account after 45 days, whether insurance has paid or not. We will be glad to send a refund to you if your insurance pays us. Although rare, some insurance carriers will not reimburse our office directly. In such instances, you will be responsible for the full cost of each visit at the time services are provided, and your insurance company will send you the reimbursement check directly.

Insurance is a contract between you, your employer and the insurance company. We are not a party to that contract. We cannot be responsible for keeping up with the ever-changing policies of each individual insurance plan. Depending on your individual plan, all services may not be covered.

It is important for you to keep us informed of any insurance changes such as policy name, group and id number, or a change of employment. We are not, however, responsible for how your insurance company processes the claims or for what benefits are ultimately paid on a claim. Our office bases treatment on your child’s needs, not what your insurance will pay. Insurance payments are determined by the benefit package that your employer purchased. We have no way of knowing if, or what, your insurance company will pay until the actual claim is submitted. Therefore, all account balances which have not been paid are the responsibility of the parent/guardian.

PLEASE NOTE: Many plans have frequency limitations pertaining to a number of the procedures done in our office. These limitations may change from benefit year to benefit year. If you are concerned about coverage for these services, please contact your insurance company prior to your visit. We cannot accept responsibility for negotiating a disputed claim and allow a maximum of 45-days for your insurance company to clear account balances. We will assist you in dealing with the insurance company but ultimately the responsibility lies with you. If after 45 days, the insurance company hasn’t paid the balance, payment will be due, in full, by you.

Payment

Payment for professional services is due at the time that dental treatment is provided. Payment options include the following:

• Cash
• Checks
• Visa, MasterCard, Discover, Amex
• Care Credit

Monthly payment plans are available. You may discuss definite financial arrangements with our office manager. Please be aware that the parent bringing the child to our office is legally responsible for payment of all charges.

For separated or divorced parents: the parent who brings the child to the office is legally responsible for payment of fees charged for that child’s care. If another agrees to payment responsibility, that person must provide a notarized acknowledgment in writing of their desire to pay for care. It is the responsibility of the person bringing the child to the office to obtain a written agreement and to inform the other person of care being provided.

Please do not hesitate to ask questions about our financial policy. We want you to be comfortable in dealing with these matters. If you have any questions regarding your insurance, we ask that you contact your company regarding the specifics and details of your plan or the office for additional information or assistance at 347-292-1757.

Open Bright Pediatric Dentistry will make every effort to keep down the cost of dental care. 
We believe everyone should be able to have a bright and healthy smile.