Pediatric Dentist in New Jersey - Dr. Shari Summers
Pediatric Dentist in New Jersey - Dr. Shari Summers

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Pediatric Dentist in New Jersey - Dr. Shari Summers
Pediatric Dentist in New Jersey - Dr. Shari Summers
Dr. Shari Summers
Office Info

How are appointments scheduled?    |    Do I stay with my child during the visit?    |    Emergencies

What about finances?    |    Our Office Policy Regarding Dental Insurance

 

office info

How are appointments scheduled?

The office attempts to schedule appointments at your convenience and when time is available. Preschool children should be seen in the morning because they are fresher and we can work more slowly with the child for their comfort. School children with a lot of work to be done should be seen in the morning for the same reason. Missing school can be kept to a minimum when regular dental care is continued.

Since appointed times are specially reserved for your child, we ask that you make every effort to arrive promptly, and please notify our office 24 hours in advance of your scheduled time if you are unable to keep your appointment. Another patient who needs our care could be scheduled if we have sufficient time to notify them. We realize that unexpected things can happen, but we ask for your assistance in this regard.  Please realize that since all our patients are children, we cannot promise afterschool times to everyone but we will try to be as accommodating as possible. 

Do I stay with my child during the visit?

Parents are invited to participate in the child's dental visit.  On some occasions, a child might benefit from separation during the visit.  We may suggest using the parent as a “reward” for good behavior.  The child will come back alone and the parent will be invited to come back after a few minutes.  If this is the case, we ask that you allow our staff to accompany your child through the dental experience.

Emergencies

Emergencies are a common occurrence with children and our office responds to these events promptly.  Kindly dial the office number 973-992-5555 and follow the prompts and we will return your call as soon as possible.

What about finances?

We have determined reasonable fees for the professional services we provide. Fees are based on the treatment necessary and the time required for completion of the treatment, depending on the individual case.  Since billing is a costly and time consuming practice we respectfully request payment at the time these services are rendered. If extenuating circumstances prevent prompt settlement of your account with us, please discuss this with us personally so that we can make the necessary arrangements.

Please be aware that the parent bringing the child to our office is legally responsible for payment of all charges. Payment is due at the time that services are rendered and can be made by cash, check, Visa, and Mastercard. We are Delta Dental Premier and PPO Plus Plan Participants.  Every effort will be made to provide a treatment plan which fits your timetable and budget, and gives your child the best possible care.

Our Office Policy Regarding Dental Insurance

Parents are urged to know about their dental insurance coverage. Please bring all insurance cards and/or forms with you to the appointment. This office is in network for Delta Dental Premier and Cigna Dental Savings. We will submit and accept assignment of benefits for most other insurances and you will be responsible for your estimated portion at the time of services based on a complimentary benefits check for your plan provisions. Our staff will assist you in getting the maximum benefit from your dental insurance.

PLEASE UNDERSTAND that we will file other dental insurance claims electronically as a courtesy to our patients. We do not have a contract with your insurance company, only you do. We are not responsible for how your insurance company handles its claims or for what benefits they pay on a claim. We can only assist you in estimating your portion of the cost of treatment; we at no time guarantee what your insurance will or will not do with each claim. We also cannot be responsible for any errors in filing your insurance; once again we file claims as a courtesy to you.

We are dedicated to providing out patients with superior dental care. However, there may be times when the recommended treatment may not always be covered by your dental insurance, even if we participate with the plan.

Each insurance plan has different benefits and if you would like to know your exact coinsurance/responsibility please request a predetermination. A predetermination may take up to four weeks to be processed and might delay treatment, but we will be happy to provide you with this service.

Fact 1 - NO INSURANCE PAYS 100% OF ALL PROCEDURES
Dental insurance is meant to be an aid in receiving dental care. Many patients think that their insurance pays 90%-100% of all dental fees. This is not true! Most plans only pay between 50%-80% of the average total fee. Some pay more, some pay less. The percentage paid is usually determined by how much you or your employer has paid for coverage or the type of contract your employer has set up with the insurance company.

Fact 2 - BENEFITS ARE NOT DETERMINED BY OUR OFFICE
You may have noticed that sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist's actual fee. Frequently, insurance companies state that the reimbursement was reduced because your dentist's fee has exceeded the usual, customary, or reasonable fee ("UCR") used by the company.

A statement such as this gives the impression that any fee greater than the amount paid by the insurance company is unreasonable or well above what most dentists in the area charge for a certain service. This can be very misleading and simply is not accurate.

Insurance companies set their own schedules and each company uses a different set of fees they consider allowable. These allowable fees may vary widely because each company collects fee information from claims it processes. The insurance company then takes this data and arbitrarily chooses a level they call the "allowable" UCR Fee. Frequently this data can be three to five years old and these "allowable" fees are set by the insurance company so they can make a net 20%-30% profit.

Unfortunately, insurance companies imply that your dentist is "overcharging" rather than say that they are "underpaying" or that their benefits are low. In general, the less expensive insurance policy will use a lower usual, customary, or reasonable (UCR) figure.

Fact 3 - DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED
When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume the fee for service is $150.00. Assuming that the insurance company allows $150.00 as its usual and customary (UCR) fee, we can figure out what benefits will be paid. First a deductible (paid by you), on average $50, is subtracted, leaving $100.00. The plan then pays 80% for this particular procedure. The insurance company will then pay 80% of $100.00, or $80.00. Out of a $150.00 fee they will pay an estimated $80.00 leaving a remaining portion of $70.00 (to be paid by the patient). Of course, if the UCR is less than $150.00 or your plan pays only at 50% then the insurance benefits will also be significantly less.

MOST IMPORTANTLY, please keep us informed of any insurance changes such as policy name, insurance company address, or a change of employment.

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Dr. Shari Summers

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Pediatric Dentist and Orthodontist, Livingston, NJ  07039 - Dr. Shari Summers    Serving patients in the surrounding cities and areas of Livingston, West Orange, Orange, Millburn,
Short Hills, Roseland, Essex Fells, Newark, Florham Park, Maplewood, South Orange, East Hanover, Whippany, Cedar Grove, Montclair, West Caldwell, North Caldwell,
Caldwell, Springfield, Summit, Chatham, Glen Ridge, Parsippany, Montville, and Fairfield, New Jersey.

 

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315 East Northfield Road - NJ 07039  ~ 973-992-5555
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