Just to add .....
Insurance companies are in business to make money. One way is to play the waiting game on providing the ins. benefit. With ortho ..... most insurance companies will not provide the entire $1000 or $1500 or whatever in one chunk payment. They realize that ortho is treatment carried out for a period of time (12-24 months). They will pay annually, semi-annually, quarterly, and some monthly. If at any time .... the patient loses that benefit (laid off, changes job, changes health/dental plan, etc. etc.) .... any remaining benefit is lost forever. Oh. Patients just love to hear when they lose some or most of the ortho ins. benefit only to have that amount tacked on to their patient responsibility portion.
Yep. The insurance game. Say your office manager forgets to file the insurance claim on a new ortho start. 6 months goes by. Some sleazy insurance companies will not allow you to file the ins paperwork on treatment that was already started.
How about when the insurance company states that they will pay 50% of the total tx fee not to exceed .....say $2000. In other words .... to get the FULL insurance benefit .... your ortho fee needs to be at least $4000. Anything less means the insurance benefit will be less than $2000. Knowing this .... how many ortho practices have "adjusted" the total fee so that the patient (practice) can collect the entire amount?
And these are the good insurance types: indemnity. Then you have the PPO/HMO stuff which further dictates your fees.