We are happy to hear that you are taking the time to understand your dental reimbursement! Usual and Customary Rates are limits set by each Insurance company. Our fees generally fall within the 90th percentile, which means that 90% of the dental offices in this demographic area are charging what we charge. We often hear that we are charging a little less than other area offices. There may be a service or two where we charge a little more. We set our rates to fall within the 90th percentile and feel that our fees are fair. When your insurance company states that we are charging above the Usual and Customary, it is simply that their set limits are below average for this area. If we do not participate with your insurance carrier, we are not obligated to reduce our fees to fit their lower fee limit. This UCR disclaimer is a misleading statement from your insurance carrier that Dental offices have been addressing for years. If we do not participate with your insurance company, our fees are not a factor in determining your reimbursable benefit, and your benefits will be paid from that company’s limited reimbursement schedule. You will be responsible for any difference.
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