First and foremost, any dental treatment you decide to pursue must be worth it.  That is, the expected outcome justifies the necessary time, effort and cost to have that treatment done.  We are committed to providing the highest possible level of care in way that is comfortable, affordable and workable for you.

Payment for your initial evaluation is due at the time of that visit, even if you have dental insurance.  Once an appropriate treatment is determined for you, the entire cost of the necessary care will be explained to you along with payment options to make sure that the care is affordable for you.  Interest-free payment plans are available for patients who qualify through CareCredit.

 Since he is a specialist, Dr. Donley does not participate with any insurance plan.  However, we still accept assignment of benefits for all insurance companies.  As a courtesy to you, we will fill out your insurance forms and submit them to your carrier. 

Payment is due at the time service is rendered.
We accept assignment of benefits from all companies.  Most companies will send insurance payments directly to us.  If we are able to pre-determine the benefits payable for your treatment you will only pay the estimated co-payment portion at the time of your visit.  Once all insurance has been paid, however, you will be responsible for any unpaid balance regardless of the level of insurance coverage.

Some companies will only send insurance payments directly to you.  We will be glad to submit the necessary forms on your behalf.  However, in these instances, you must pay the entire balance at the time of treatment.  You will then be reimbursed directly by your insurance company.  You are ultimately responsible for the entire cost of your care.

We offer interest-free payment plans.  Please ask the receptionist for details.

Why 100% coverage does not necessarily mean 100%
The services covered under your plan are selected and paid for by your employer.  Your employer negotiates with the insurance company as to how much the insurance company will allow for a specific procedure.  We have absolutely no input or control over how much an insurance company will allow for a specific procedure.

When your policy states it will cover 100%, it means it will cover 100% of the arbitrary fee that the insurance company has negotiated with your employer for each procedure.  Although this fee is called usual and customary, insurance carriers set this fee without ever surveying the fees charged by dental specialists in the area.  No insurance company has ever asked to see our fee schedule.  

We set our fees to allow us to do what we need to do and to achieve the best results.  We use the best materials and the latest technology.  We do not cut corners.   If the necessary fee for our care exceeds the arbitrary fee set by the insurance company you are still responsible for paying the balance of our fee. 

Why we do not participate with any plan.

As a way to minimize payouts, insurance companies try to contract with dentists to be a participating provider with their plan.  Specialists, like periodontists, usually do not participate in insurance plans.  When periodontists agree to participate in an insurance plan they agree to lower their fees to a level determined by the insurance company.  In turn, the insurance company agrees to list that periodontist as a preferred provider.  The motivation for the specialist is to get more patients into their offices.  Participating offices are forced to make up for the lower fees by seeing more patients, providing treatment that may not be immediately necessary,  and performing more procedures in less time. 

Our office is not comfortable with that approach.  The fee reduction for specialists that participate in these plans is significant.  Knowing full well that you get what you pay for, we have made a conscious decision not to provide cut-rate care.

Why "I only want what my insurance covers," is a mistake.
The services covered under your plan are selected and paid for by your employer.  Your employer has a choice in the level of coverage they buy for you.  Employers often make this choice based on their best profit, not based on your best health.  They may or may not cover all of the care that you need to improve your oral and overall health.  If they don't cover a particular service or procedure, and you need it to get well, it may be beneficial to tell human resources at your place of employment to buy better coverage for you the next time they update your plan.   

In the meantime, you have to decide if it is worth paying for the necessary care yourself.  Rest assured, we will only recommend care if we are sure that it is worth it for you in the long run.  We want the expected outcome to justify your involved time, effort and cost. 

Many insurance companies have a yearly maximum of a $1000-$1500.  Dental insurance is not cumulative, so if you don't use it in a given year, you lose it.  It is interesting, and disappointing, to note that when dental insurance companies became common in the early 1970's, the yearly maximum in many was the same $1000 it is today even though the cost of delivering dental care has nearly tripled since then.