Fees
What is our full fee for a crown?
$1861
What is needed to send SRP's to insurance?
Updated bitewing and perio chart within 6 months and FMX within ins freq (3 or 5 years)
What x-rays are required for a bridge with an extraction?
Current FMX/PANO (within 3-5 years depending on the ins)
Reminder! Always need an updated pano for extractions!
Patient has a federal dental insurance plan, what else do you need to know from the patient?
Must know BCBS FEP medical insurance information. This must be entered as primary insurance (Look at M.Tjaden account for reference)
What is a 2X12 month frequency?
Rolling months not a calendar year.
EX. 12/05/2025 & 06/7/2026
Next eligible would be after 12/06/2026.
(It's 12 months from the 2nd to last cleaning)
What is the fee for our KFD Plan?
$378
What information is needed for a claim on a tooth that has an existing crown?
PA within 6 months- must show the entire tooth
Age of existing crown- Month and year
Always commlog this info!
Why is it important not to send the PANO to insurance at the sametime you take an FMX?
Insurance will either pay for a pano OR an FMX not both.
Insurance will always choose to pay for the cheaper service which would be the PANO.
What is needed for a minor to been seen?
Signed HIPPA listing a guardian and/or parent.
Guardian or parent must be attached to their file as a non patient if they are not a current patient. Always list them as the guarantor.
What is the doctor recommended frequency for Orthotic adjustments?
1st- 2 weeks after delivery (no charge)
2nd- 1 month after 1st adjustment (Patient pays for this one)
Patient to bring their orthotic to their hygiene appts and if an adjustment is needed, we will work the patient into our schedule.
Are we in network with Aetna Fee Schedule?
NO!
What do we need for a bridge estimate where the patient is missing 3 teeth in the same arch?
FMX within 3-5 years depending on the ins freq
Does the pt have an existing restoration or removable?
How old is the existing?
How long have the teeth been missing?
Always commlog this info!
At what age do we start taking PANO's on children?
5 Years old.
Are we in network with DHL and INO Plans?
NO!!
THESE ARE HMO PLANS
How much is an LEPA without insurance?
$200
If there is no fee listed for a procedure in Open Dental what is the fee?
What information do we need for a partial estimate?
FMX/PANO
Are we replacing an existing partial or bridge?
Dates of existing or old partial or bridge
When were the teeth extracted?
Always commlog this info!
What is the difference between these two PA's?
PA Intraoral - Periapical first radiographic images and PAadd Intraoral- Periapical each additional radiographic image
PA intraoral is for the 1st PA set complete and the PAadd is for any additional PA's taken.
How do you determine primary and secondary?
a. Children/ b. Spouse / c. Medicare Plan
a. Birthday rule (follows the earlier month in the year between mom and dad not year of birth)
b. Pt's employer's plan is primary then spouses is secondary
c. No matter what Medicare is primary
How old can a PA of a tooth be to present an estimate for a crown?
Less than 6 months.
What fee schedule has dollars and cents listed as their fee?
Dentemax
What must you have for insurance to even consider anterior crown coverage?
Full PA within 6 months. Needs to show entire tooth including the incisal edge and root.
What do you need to know when preparing an estimate for retainers?
Initial set of retainers or a replacement set? Indicate replacement date in commlog.
Initial set vs replacement set have different ADA codes and fees! We also charge per arch for retainers!
$420
1st appt - patient comes in for custom whitening trays (we take an impression)
2nd appt - patient returns a week later to try in the trays, team explains the whitening process and give pt 4 tubes of whitening
What is required for treatment planning an implant?
Evaluation by a doctor/IM Sheet filled out by doctor
X-Rays (PA,PANO/FMX within ins freq)
How long has the tooth been missing if the tooth is already missing?
Was there a previous restoration on that tooth? Be careful! Crowns share freq with IM CR's!