What is Direct Billing?
Direct billing is the process where we, Seoul Ace Dental Clinic, bill the patient’s insurance company directly. It saves you as our patient from having to pay yourself as well as having to do all the paperwork on your own.
At Seoul Ace Dental Clinic we try to make your visit as pleasant as possible. That also includes the payment process.
How does direct billing work?
If you or your family has dental insurance coverage, we will get in touch with your provider and submit a claim on your behalf.
To make the process as smooth as possible, you should be familiar with your dental insurance plan coverage before coming to the appointment. If you wish, we can send a predetermination to your health insurance to identify how much will be covered exactly for a specific procedure.
The insurance process is not finished until after your visit. The insurance companies require proof of your appointment before providing coverage. We handle that paperwork with pleasure as a service for your, so you don’t need to concern yourself about being reimbursed.
What do you need to do?
You are ultimately responsible for providing us with all the necessary information about your insurance provider including your personal identification number. Please talk to our front desk staff in the beginning of your appointment.
Our clinic is not aware of the details of your insurance plan until your give our staff permission to process your claim. Since each insurance plan is different, it can happen that you are responsible for the remaining balance after the insurance coverage has been deducted. This is done at the end of your appointment.
What Direct Billing Agreements do we have?
We currently have a number of direct billing agreements with the insurances stated below. The
Common Insurance Terms for direct billing
- Maximum: This is the total amount of money your dental plan will pay during the plan year. If the annual maximum is reached, you have pay any outstanding amount yourself. Your dental plan may specify a different maximum for preventive treatment, basic treatment and major treatment (implants, crowns, bridges etc).
- Coverage Year: Depending on your insurance, your coverage may be based on a policy year or on a calendar year.
- Deductible: A deductible is the amount of money that you as a patient have to pay before a benefit plan will pay for any service. A deductible may be per individual or per family.
- Fee Guide: An insurance company may set its own fee guide and will reimburse you as a percentage of that rate. Hence, even if your insurance plan states that it provides 100% coverage, the coverage rate may be based upon the fee guide and not that of our dental clinic.
- Co-Insurance: The co-insurance determines how much the insurance company will cover. If the coverage is at 80%, you as a patient pay the remaining 20%.
- Frequency Limitations: It is common that insurance companies limit the frequency of particular services such as exams, cleaning, fluoride or x-rays.
If you have any further questions, feel free to to get in touch with us here. We are happy to assist you with your claims.