Medical Insurance Guide

Once your consultation is booked, our front desk checks your plan before you come in, so you can make decisions on real numbers rather than hopeful ones.

The timeline

1. We book your consultation When you can wait, we schedule it at least three business days out, so the check finishes in time. If you are in pain, we see you sooner and check your benefits at the same time.
2. We check your plan We confirm your plan is active and how much of your deductible and out-of-pocket amounts remain. For a Medicare Advantage or PPO plan, we also call the plan and ask what it allows for medical procedures of the jaw, and whether it needs prior authorization (advance approval).
3. We call you back At least two business days before your visit, we tell you in plain language what we learned.

What you will hear on that call

• Whether your plan is active
• The deductible and out-of-pocket amounts remaining
• Whether jaw procedures are a benefit under your medical plan when medically necessary
• Whether prior authorization is required (if it is, our office handles it)

With traditional Medicare (the red, white and blue card), there is no benefits call to make and no prior authorization. Medicare decides on medical necessity when it receives the claim, so we confirm your Part B status and deductible instead.