Insurance FAQs


(1) What role does AOSC play regarding my insurance plan(s)?

  • Keep in mind that your insurance policy is a contract between you, your employer, and/or the insurance company.  
  • AOSC is not a party with your insurance contract.
  • Our relationship is with YOU, not with your insurance company.  This allows our doctor(s) to properly treat you through a clinical evaluation without the influence of an insurance company dictating treatment.
  • AOSC will submit your insurance claim (Dental and/or Medical) as a courtesy.
  • The patient is responsible for all charges at the time of service.

(2) Which documents does my insurance company require?

  • Patient’s driver’s license
  •  Patient’s DOB and Social Security Number (SSN)
  • Dental insurance information (primary and/or secondary)
  • Medical insurance information (primary and/or secondary)
  • Policy holder’s DOB and Social security number (SSN)

If any of these documents are not provided by the patient, the insurance company will not accept the claim.  The insurance company will put the claim on hold; thus, delaying your insurance check.  

 

AOSC is unable to provide any further information regarding your insurance claim until ALL documents are provided.


(3) How do I utilize my Dental insurance for a "Medical Procedure"?

If you are utilizing your DENTAL insurance and it's a medically-related treatment, it is mandatory for us to obtain a copy of your MEDICAL EXPLANATION OF BENEFITS (EOB) which will mailed to you by the insurance company.

 

**Our office does NOT receive a copy of this document by your insurance company**

**The insurance company will STOP the reimbursement process if this document is not submitted**

 

Step 1a: Mail the copy of your MEDICAL EXPLANATION OF BENEFITS (EOB) to our office address

3433 University Avenue, Suite 1

Morgantown, WV 26505

 

Step 1b: Email copy of your MEDICAL EXPLANATION OF BENEFITS (EOB)

insurance@oralsurgerywv.com

 

Step 2: Once AOSC obtains a copy of your MEDICAL EXPLANATION OF BENEFITS (EOB), our office will submit this document to your DENTAL insurance electronically for reimbursement.

 

Step 3: If you have any further questions, please contact our Insurance Coordinator, Tamika.


(4) Why is my benefit different from what I expected?

  • You have already used some or all of the benefits available from your insurance plan(s)
  • Your insurance plan paid only a % of the fee charged regarding your treatment
  • You have not yet met your deductible
  • You have not reached the end of your plan's waiting period and are currently ineligible for coverage

(5) How do I check on the status of my claim?

 Please contact your insurance company either by phone or website for further details.  AOSC is not given this information by your insurance company.


(6) How long does it take before I receive my insurance check?

It often takes between 4-6 weeks.  Your insurance company does not provide AOSC with a timelines regarding your insurance check.


Glossary of Terms:


Allowable costThe maximum amount a plan will pay for a covered health care service.  May also be called “eligible expense,” “payment allowance,” or “negotiated rate.”

Copayment (aka copay) - A fixed amount that you pay for a covered health care service after you've paid your deductible.  Copay can vary for different services within the same plan, like drugs, lab tests, and visits to specialists.  

For example, let's say your health insurance plan allowable cost for a doctor's office visit is $100.  Your copayment for a doctor visit is $20.  

  • If you've paid your deductible: You pay $20, usually at the time of the visit.
  • If you haven't met your deductible: You pay $100, the full allowable amount for the visit.

Deductible - The amount you pay for covered health care services before your insurance plan starts to pay.  After you pay your deductible, you usually pay a copayment or coinsurance for covered services. 

For example, with a $2,000 deductible, you pay the first $2,000 of covered services yourself then the insurance company pays the rest.

Primary insurance - Health insurance plan that covers a person as an employee, subscriber, or member which is billed first when you receive health care.  For example, health insurance you receive through your employer is typically your primary insurance.

Secondary insurance - Health insurance plan that covers you in addition to your primary insurance plan.  Secondary insurance may help cover additional health care costs when your primary insurance plan is exhausted.  For example, if you already have insurance through your employer and choose to enroll with your spouse’s health insurance plan (if allowed), that coverage would become your secondary insurance.


Education Materials:


Download
Introduction to Dental Benefits by American Dental Association (ADA)
ADA - An Introduction to Dental Benefits
Adobe Acrobat Document 9.1 MB


 Office hours:

Monday through Friday

(730am - 530pm)

 

 

 CALL AND SCHEDULE A VIRUAL CONSULT:

* IMMEDIATE ACCESS TO CARE

* ONE-ON-ONE INTERACTION WITH HEALTHCARE EXPERT

* IMMEDIATE ACCESS TO MEDICATION (IF INDICATED)

 

 

Call or text 

304.322.4532 


Proud to serve oral surgery to the areas of WV (Clarksburg, Farmington, Wheeling, Bridgeport, Morgantown, Fairmont, Shinnston, Weston, Grafton, Buckhannon, Parkersburg); MD (Cumberland, Deep Creek, Oakland); OH (Steubenvilleand); and PA (Uniontown, Mount Morris, Waynesburg, Smithfield, Washington). 

 

Proud to be an oral surgeon to the local schools of WV: Monongalia County, Marion County, Harrison County, Taylor County, Preston County, Ohio County, Randolph County, Marshall County, Webster County, Braxton County, Nicholas County, Upshur County.

 

Proud to serve oral surgery and dental care for patients who need dental emergency care, emergency care, dental pain, toothache, infected tooth, infection, abscess, tooth hurts, IV anesthesia, sedation dentistry, sedation surgery, IV sedation, tooth pain, broken tooth, fracture tooth, IV sedation, dental anxiety, urgent dental care.

 

Secure Your Smile™ with AOSC!