Insurance Information

At South Shore Oral & Maxillofacial Surgery we make every effort to provide you with the finest care and the most convenient financial options. To accomplish this we work hand-in-hand with you to maximize your insurance reimbursement for covered procedures. If you have any problems or questions, please ask our staff. They are well informed and up-to-date. They can be reached by phone at (281) 334-9000.
 
Please bring both dental and medical insurance information with you to the consultation so that we can expedite reimbursement.
 

Insurance

Please remember you are fully responsible for all fees charged by this office regardless of your insurance coverage.
 
We accept most dental PPO’s, some dental DMO’s, and some medical insurance plans. If you have this type of insurance, we will assist you in receiving the maximum allowable benefits under your insurance policy. We file claims on your behalf and in many cases we can receive some payments directly from the insurance provider. Most insurance companies will respond within 4-6 weeks. We do not guarantee the final payment amounts from your insurance company. If full payment from the insurance company for services on your behalf, is not made after claim submission procedures, you will be responsible for the remaining balance. Feel free to call us regarding specific plans.
We will collect a portion* of the estimated bill on the day of your appointment. We determine this amount by estimating the services we believe you will receive and then estimating the charges you will incur. Please remember this is only an estimate. It is not always possible to determine the exact charges you will require. Additional or fewer services may be necessary, in which case your charges may be greater or less than the estimate.
 

Please Feel Free to Ask Our Financial Coordinator Any Questions You May Have.

 

We will do our best to assure that you receive the maximum benefits that you are entitled to from your insurance plan. Dr. Lovoi’s diagnosis and recommended treatment is based solely on his clinical findings of your examination and x-rays. His diagnosis is not based upon what your insurance plan will or will not cover.

We accept most major insurance plans. For your convenience, we will file your insurance claim with your insurance carrier. You will be required to pay all co-pays and estimated percentages of fees prior to your surgery.

All treatment plan amounts listed as to what your insurance carrier may pay are good faith estimates based on the limited information your insurance carrier has provided us. The actual amount your insurance carrier pays depends on the specific criteria of you insurance plan. Dental and medical insurance plans may vary widely. The information we included may be helpful.

  • Dental / Medical insurance usually will not cover all of your treatment.
  • Many carriers will tell their insured (you, the patient) that they will cover up to 50%, 80% or 100%. Regardless of what you are told, we have found that most plans only cover about 50-75% of an average fee.
  • Some plans will pay more while some will pay less. The amount your plan pays is determined by how much you and/or your employer paid for the plan coverage. The less paid for insurance, the less you will received in benefits.
  • Some insurance companies will tell their customers that the fees charged are above their usual and customary fee instead of saying that their benefits are low. Remember, you get back only what you and/or your employer contributes less the profit of the insurance company.
  • Not all services will be covered by your carrier due to specific plan limitations or exclusions.

Since information provided over the phone does not guarantee coverage or payment, we strongly recommend a written pre-determination prior to treatment in order to more accurately know the benefits your insurance carrier will pay.

If your insurance carrier pays more than the amount we estimated, you will receive a refund from our office. If your insurance carrier pays less than the amount we estimated, you will be responsible for the balance which is due upon receipt.

John J. Lovoi, Jr. DDS is not a provider for the Medicaid or the Medicare program. We do not file nor do we accept Medicaid or Medicare coverage. Full payment will be due prior to any services rendered for these patients.

Please contact us at 281-334-9000, should you have any questions about our services, treatment or policies.