What to Expect
Receiving orthodontic care is a huge decision. The Hometown team will be by your side at each step and is committed to providing you with innovative, safe and efficient treatment options. We are also committed to providing you with the best personalized care that is tailored to meet your needs so you can put your best smile forward. It’s a simple process that involves a complementary initial consult, treatment start and regular appointments. Click below to learn more:
Initial Consultation: Meet Dr. Virdee and Assess your Needs
During your first visit, our goal will be to get to know you and your teeth – and of course, this is a great opportunity for you to meet the team and ask questions. This appointment is complimentary, and by the end of exam, Dr. Virdee will recommend treatment options for you based on your diagnostic records, personal goals, timelines, and budget. Dr. Virdee will also take the time to answer all your questions so that you understand everything that you need to know in order to proceed with treatment. Ultimately, we want you to feel confident that your dental health and smile is in the best hands before you begin treatment with us. You can expect the following:
1. Review of dental and medical history forms
2. Complete a thorough examination with a digital panoramic x-ray and photos
3. Explanation of findings, recommend treatment and estimated treatment time
4. Create a customized treatment plan and treatment options specifically for you
5. Discuss all financial information, insurance options, and payment plans
Starting treatment: Your First Steps to LIVE. LAUGH. SMILE.
Your second appointment marks the initial step in the journey to achieving a confident, youthful, and healthy smile. Be ready to start your treatment on this day. The Hometown team will begin the treatment that was discussed and agreed upon in your initial consultation. This is also a great opportunity to ask follow-up questions and discuss any other treatment related issues with Dr. Virdee.
A vital key to your treatment success will be regular check-ups with Dr. Virdee. We suggest intervals of every eight to ten weeks. Our team will work with you to ensure that appointments are convenient and fit your schedule. For best results, visiting your family dentist once every six months for routine cleanings and dental check-ups is vital, even during your orthodontic treatment. The Hometown team can help coordinate this for you too! We look forward to transforming your smile and getting to know you during your orthodontic journey with us!
At Hometown Orthodontics we make a commitment to providing you with affordable, high-quality treatment that fits your budget! We know that the cost of braces or Invisalign plays a factor in deciding whether to commence treatment. However, we believe that financial considerations should not be an obstacle to obtaining a confident and healthy smile. As a result, we offer the following payment options to meet your needs:
Low Monthly, No Interest Payment / No Initial Payment
Prepayment Courtesy for payment in full prior to treatment by credit card.
Please ask us about financing options, credit card payments and bank drafts. We thoroughly explain your options so that we can accommodate your needs.
Initial Payment Plan
A down payment of approximately 10% is made at the start of treatment for any patient wishing to start treatment with Invisalign, with the balance paid monthly over approximately 24 months of the treatment time. For patients who start treatment with clear braces or metal braces, we ask that you pay the first monthly instalment based on your payment plan. We have flexibility in our monthly instalments as well, so please don’t hesitate to speak with us so that we can accommodate your financial needs. We accept cash, check, and credit cards for the Initial Payment Plan.
Company Flex Plan
Your company may offer a medical spending account, which allows you to set aside pre-tax dollars to pay for your medical expenses. Please contact your employer for more details.
If your insurance covers orthodontic treatment, you will receive the benefit of reduced personal costs. Many insurance policies have a lifetime orthodontic benefit that is distinct from regular dental insurance. Remember that insurance policies vary, and we will review your insurance to determine the appropriate course of action. Once treatment has started, we will file your claims. No down-payment, no-interest monthly payment plans are available. We also accept Visa, MasterCard and Interact.
At Hometown Orthodontics, we strive to give you outstanding treatment results, while utilizing your insurance coverage and other benefit plans effectively.
There are a great number of orthodontic coverages available depending on what your employer purchases. Many patients incorrectly believe that just because they have dental insurance, their insurance company will also cover orthodontics under the same umbrella. This is not always the case. It is very important that you become knowledgable about your orthodontic insurance coverage prior to your initial consultation with Dr. Virdee. This will allow you to make a more informed decision about treatment with us. The following is a few key questions to ask your insurance company:
Do I have orthodontic coverage associated with my dental insurance?
If I do have orthodontic benefits, what is the lifetime maximum payable?
What kind of fee schedule is used to pay out the benefit?
Is there a deductible that applies to orthodontics?
Is there an age limit pertaining to orthodontic benefits?
Predetermination of Insurance Coverage
Once treatment is recommended by Dr. Virdee, we provide you with a pre-determination form that is submitted to the insurance company. This form provides an overview of Dr. Virdee’s proposed treatment plan and gives the the insurance company several pieces of key information including the Dr. Virdee’s clinical findings, total treatment fee and approximate length of treatment.
After the insurance company processes the predetermination, they will mail you an Explanation of Benefits (EOB) form which details, in writing, the benefits the insurance company expects to pay for your treatment. As with the actual insurance benefits themselves, EOB’s can come in a variety of formats and some are easier to read than others. At this time, if you have questions about what is or isn’t covered, you can either call your insurance company directly, or you are always welcome to contact us for additional information.
Multiple Insurance Coverage
For clients with coverage from more than one insurance policy, there are general rules designated by your respective insurance companies for how to manage payment with the different policies.
Primary and Secondary
In general, if there is a primary insurance and a secondary insurance, the policy that is primary is the one to which you are the subscriber. A secondary policy is one where you are covered under someone else’s policy. These are not choices you can make, but rather determined by your insurance company.
Consideration & Types of Secondary Claims
There are many different ways an insurance carrier considers secondary claims. Coordination of Benefits (COB) is the typical way insurance carriers deal with more than one insurance carrier. Basically the two insurance carriers would coordinate the benefits between each other in order to pay 100% of the fee charged but not to exceed the charge amount, so the client or the doctor would not profit from being over compensated for the expenses.
The other types of calculating secondary insurance are Maintenance of Benefits (MOB), Carve Out, Limited Coordination, Non-Dual and Integration of Benefits. All of these types usually do not pay anything secondary. The contract language is written so that if the primary carrier paid the same or more than what the secondary carrier would have paid if they had been primary, then they (the secondary carrier) is not responsible for any payment at all. (It would be a duplication of benefits).
Integration of Benefits, the toughest form of non-duplication, means the sum of the total benefits paid by either carrier may satisfy the maximum of the secondary carrier. For example, if the secondary carrier has a plan year maximum of $1500.00, and the client had a $3000.00 bridge or oral surgery paid at 50% by the primary plan, the secondary carrier says it has satisfied its maximum for the entire plan year even though it was the primary carrier that paid the $1500.00! The secondary carrier hasn’t paid anything, but it has satisfied its maximum.
It is so important when verifying benefits to find out exactly how the insurance company handles secondary claims.
Remember when submitting “pre-treatment estimates,” all carriers estimate their benefit payment as if they are primary.
The designation of which policy pays first for dependents again depends on the rules of your insurance company. The typical rules for dependents of parents not separated or divorced with overlapping coverage rely on birthday of the parent, gender of the parent, or some other rule. For divorced/separated parents, specific custody rules usually apply, unless some specific arrangement is agreed to by each party. These designations are unique to each particular insurance.
When Does Secondary Pay
Usually, the secondary policy will not usually accept a claim until after the primary claim is paid, and then the secondary policy will often require a copy of that payment information (referred to as an EOB, explanation of benefits).
Will you get the percentage reimbursement stated during the initial phone verification? Maybe.
Any reimbursement would be subject to the conditions and restrictions of your particular plan. If you have any questions about what treatment is covered, please be sure to contact your insurance company (you will likely require specific information such as treatment codes). The percentage of reimbursement from your insurance company is determined by their fee schedule, which is not related to local dentists’ fees. The percentage of insurance reimbursement DOES NOT mean you will receive that percentage of fee you are charged, just that percentage of what the insurance has agreed to pay in their contract with you and/or your employer.
Make an appointment to see Dr. Virdee today for a no-cost initial consultation
and see why Hometown Orthodontics gets the best grades for patient care!