Online Dental Education Library

Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.

 

INSURANCE

Usual and Customary. What Does It Mean?

 

Every once in a while a patient calls us after receiving a statement from their dental insurance company and asks: “Your fee for this is over what my dental insurance company calls ‘usual and customary,’ does that mean you are overcharging me?” 

That’s a good question, one we’re happy to answer. 

Each separate insurance company has its own “usual and customary” fees for all dental procedures for a certain geographical region. When our state dental association asks these companies for data to see how the numbers were arrived at and which dentists (if any) were surveyed, they are told that this is privileged company information and they do not reveal that. 

The fact is that different insurance companies have different “usual and customary” fees for the same area.  If the calculations were done correctly they should all have the same fees.  But they don’t! In fact the ranges are quite broad. 

Because the insurance companies establish artificially low fees in an effort to keep their profit margins as high as possible, animosity can be created between the dentist and the patient.  The insurance companies’ main goal is to collect as much in premiums as possible while paying out as little as possible and delaying payment for as long as possible. That is how they make their money.  Unlike us, they do not have the patients’ best interest at heart.

What is Dental Insurance?

Dental insurance is nothing more than a contract between the employer and the insurance company to partially pay for certain services.  It exists to help in covering the costs; it was never intended to cover all the costs. There are deductibles, some services get paid at 50 % or 85 % and some aren’t covered at all. 

The type of insurance coverage your employer is willing to buy is determined by how much the employer is willing to pay for.  The employer selects as many or as fewer benefits they want.  The higher the premium paid by your employee – the higher is your usual and customary fee.

How Are Our Fees Set?

Our fees are set by the actual cost of doing business in this particular office.  Costs vary from office to office depending on rent, the salaries of out employees, quality of materials used, lab costs and many other "cost of doing business" factors.

For example, we will not compromise on sterilization because it’s just too important for our patients.  Likewise we will not use inferior materials for our dental restorations just to “save money”.  The fact is you never save money this way because the cheaper materials don’t last as long and the patient ends up back in the dental chair in a few years complaining that their crown or filling failed. We hire only the best, well trained staff, who love their jobs and give 110% every day to our patients care and customer service.

                          (information taken from Dr. Alex Shvartsman)

 



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  • Invisalign® is the invisible way to straighten your teeth without braces.
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How Does Invisalign® Work?

  • You wear each set of aligners for about 2 weeks, removing them only to eat, drink, brush, and floss.
  • As you replace each aligner with the next in the series, your teeth will move little by little, week by week - until they have straightened to the their final position.
  • You'll visit us about once every 6 weeks to ensure that your treatment is progressing as planned.
  • Total treatment time averages 9 - 15 months and the average number of aligners during treatment is between 18 - 30, but both will vary from case to case.

How Are Aligners Made? You'd Be Amazed...

  • The aligners are made through a combination of our expertise and 3-D computer imaging technology.

Visit the Invisalign® website