Connecticut Maxillofacial Surgeons, LLC has gone to considerable effort to provide you with the most sophisticated, efficient and comfortable ways of handling your account. We understand that the issue of cost surrounding healthcare is something uncomfortable to discuss. Similarly, as doctors we would prefer to return to the “days of old” when finances seemed to take care of themselves as you entered the doctor’s office. However, the current healthcare environment has left us with no alternative but to have an early dialogue between us. It is through up front communications that we hope to mitigate some of the otherwise painful financial experiences that can occur when seeking medical assistance. Please do not hesitate to ask questions about fees, methods of payment (credit cards, payment plans, etc.), and methods of obtaining credit. We want to help you if we can.
Connecticut Maxillofacial Surgeons, LLC has attempted to simplify your financial transactions with us by providing you with the following:
Centralized Billing – Although we are located in five different offices, your billing statements will be generated from our central billing office and corporate headquarters in Farmington. Centralized billing allows us to provide consistent answers to your questions, initiate timely third party claims through electronic billing, and give you a single number to call to obtain further information about your account.
Walk-Out Statements – If for some reason we do not participate with your third party payer, you will be provided the convenience of a walk-out statement that may be easily attached to your insurance form with the proper coding and charges. This should expedite payment back to you if you are required to cover your initial expenses with us from your own pocket.
MasterCard and/or Visa – Yes, you may pay for the services rendered with either MasterCard or Visa. This is possibly one method of payment if you are initiating elective treatment that is not covered by your third party payer. Additionally, it is a method to possibly float your down payment on surgery while you are waiting for third party reimbursement. Sorry, we do not take American Express at this time.
The Ability to Obtain Credit – We currently participate with a lending institution by the name of CareCredit who will often respond to your request for credit literally while you wait. Obtaining credit by this method requires only a brief inquiry from our staff and a short application. Let us help you pay at your own rate by putting you in touch with CareCredit. To obtain additional information regarding CareCredit or how you might qualify for this service, please click the link below. If you would rather speak with a representative from our office, please do not hesitate to call us and we will do our best to assist you.
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Our Current Policy On Payment For Services
When you contact one of our offices for an appointment, in addition to other questions that you may be asked (see “Making An Appointment“), the receptionist will speak to you about the following specific issues surrounding your financial obligation with us:
- What is the purpose of your consultation (e.g., to have my jaw fixed; my orthodontist sent me; to have my wisdom teeth out, etc.)? By asking this question, we will begin to understand under what category your treatment will fall and whether it is of medical origin, dental origin or both. When assisting you with questions about your insurance this will help her determine whether your treatment is likely to be a covered expense in your specific insurance plan.
- The name and nature of your insurance carrier. Unfortunately, in today’s healthcare environment, the name of your insurance company is sometimes the most important information that you will provide to us. It is frequently necessary that we notify your primary care physician of your intent to visit us so that you may obtain what is called a “primary care referral.” Some insurance companies will refuse to pay for your visit if this is not obtained prior to your initial consultation with us. Please let us assist you in procuring the necessary credentials to maximize your insurance benefits and minimize your hassle.
- Payment is due at the time services are rendered. After establishing the purpose of your visit, the receptionist will advise you of an approximate anticipated cost of your first visit. No one appreciates a surprise when it relates to financial matters and you should not hesitate to discuss your concerns about finances with her. In keeping with policies that have been established by our doctors the receptionist may request that you bring anywhere from 50% to 100% of the anticipated fee with you at the time of your visit. Payment for services is expected at the time the service is rendered. Exceptions to this policy resulting from special circumstances will be considered on a case by case basis and should be brought to the attention of the receptionist and/or billing department as soon as possible. We will not turn away patients who are suffering from emergent medical situations (infections, trauma, etc.) and/or patients who may be experiencing an undo amount of pain.
Your Insurance and Us
The formation of Connecticut Maxillofacial Surgeons, LLC, was, in a small way, secondary to the demands placed upon providers to be linked with various third party payers. In the process of developing “preferred provider” lists, some insurance companies would restrict your access to a doctor with whom you were already familiar or to whom you had been referred. By expanding our provider base, we hoped to make our services available to nearly any patient with nearly any third party coverage. “Hope springs eternal,” but we have found that chasing the third party payer quagmire is only surpassed by staying on top of the most current federal tax code. At the very moment you are certain that you understand the rules, changes to those rules are being implemented. You might think that both the insurance industry and the internal revenue service are in the business of keeping you confused and unknowing. Well, if you think that, you are probably right.
It is common for the discriminating patient to call our office for an appointment and have as their first question whether we (CTMAX) or our individual doctors are “participating providers” with their insurance plan. While seemingly a simple and relevant question to ask when attempting to determine what financial obligations you will have when visiting our office, unfortunately, the oral and maxillofacial surgeon falls into a unique category of providers. A simple answer of “yes” or “no” to this question by the receptionist just does not accurately reflect the realities of your future financial obligations with us or with any other oral and maxillofacial surgeon for that matter. A brief explanation of the situation is indicated and may serve to provide you with a better understanding of the complexity of what appears to be a simple question. Therefore, we will take a second here to clarify what questions you should ask when seeking accurate information about your insurance and the oral and maxillofacial surgeon.
Is Your Proposed Treatment Medical or Dental?
In the eyes of the insurance industry, the specialty of oral and maxillofacial surgery is an orphan and really belongs to neither medicine nor dentistry. Why is that? Well, if the truth be known, we provide services that are considered an integral part of both health disciplines. If you have even spent a few minutes browsing our procedures section you would have seen surgical procedures that would be considered by most as procedures performed by a medical specialty and others that would have you believe you were visiting a dental office. Adding even more confusion to the mix comes when you visit our doctors section and find that two of our doctors have degrees in both medicine (M.D.) and dentistry (D.M.D. /D.D.S.). Well, as confused as you are, so is the insurance industry…or at least they would claim to be. As a matter of convenience you can often find the claims reviewer from your medical insurance declaring that your procedure is dental and your dental insurance reviewer declaring that your procedure was medical. The fact is that neither insurance carrier wants to pay for whatever you have had done and in many cases have been instructed to deny the claim by pointing the finger at the other health discipline. “This does not fall under your policy with us; we recommend that you speak with your other insurance company.”
Is Your Proposed Treatment A “Covered” Expense?
Another area of confusion comes with whether you are actually covered for the treatment that you are seeking or is this treatment really an uncovered expense in your plan. The answer to this question is probably the most important of all when attempting to determine whether you will be covered in our office for treatment. The issue of whether your doctor is a provider in your plan is insignificant if your treatment is an “uncovered expense.” While it is unfortunate, a number of the procedures that we provide fall into this category and may result in you having to pay for a portion of your treatment out of your own savings.
Whatever the case, the staff at Connecticut Maxillofacial Surgeons, L.L.C., is highly trained to assist you with your insurance questions. We have a vast experience with the third party payer as well as often having Internet access to your benefits package if given your permission to investigate them. Rather than making the assumption that you are not covered for your treatment because we are not a provider, let us do the diligence to determine what your options are. As mentioned above, you may not be eligible to receive any benefits for your treatment even in the office of a “participating provider.” Do not let yourself be influenced by your insurance company to see a provider who you know nothing about without the proper investigation first. Your insurance company is only interested in saving themselves money, not in putting you together with the best oral and maxillofacial surgeons in Connecticut. Let us help you with your investigation and give you an honest evaluation of your situation before you spend any of your hard earned healthcare savings. We want to make your visit with us as painless as possible and that includes the pain felt when writing another check for your healthcare.
If You Would Like to Know More About Your Insurance Coverage When Visiting Our Office
Please speak with or call the receptionist in one of our individual offices to obtain specific information about your plan and any future relationships that you may have with us. Alternatively, you can call our centralized billing office at 860.678.7528, option 1 – Billing Office and they will assist you in finding answers to your questions or refer you to the proper person to help you.