Insurance Question Replies

Writes a clear, kind, honest reply to a patient who has a question about dental insurance, coverage, their estimate, or their bill.

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Before and after

BEFORE · what the owner typed

Office input: "Patient Dominga Haynes wrote: 'I got a bill for $212 and I thought my insurance would cover the crown. Why do I owe so much? Also is it ok to wait on the second crown, I cant afford both right now.' Office is Plumford Family Dentistry, 7149 Northford St, Sagecrest, phone 234-555-0174. Crown on tooth 14 done on March 3. Our fee was $1,100. Insurance estimate said they would pay $888. She already paid nothing. So the math is the $212 she owes. Insurance has not paid yet, claim was sent March 4. Dr. Dorian Hodge recommended a second crown on tooth 19. Sign it from Eli Kirby at the front desk. We offer a payment plan, she can call to set it up. I don't know what her plan's yearly maximum is."

AFTER · what the skill produced

Hello Dominga,

Thank you for reaching out. It makes sense to want to understand this bill, and we are glad to walk through it.

Here is how your crown on tooth 14 from March 3 breaks down:

Our fee: $1,100
Insurance estimate: $888
Your portion: $212

The $888 is the amount your plan estimated it would pay. It is an estimate, and your plan makes the final decision when it processes the claim. We sent the claim on March 4, and it has not been paid yet. Nothing has been collected from you so far.

About the second crown on tooth 19: Dr. Dorian Hodge recommends it, and we would be glad to talk through the options with you. Whether and when to go ahead is your decision, and we will note whatever you choose. We do offer a payment plan, and we can set one up for you if that would help with the cost.

If you have questions about what your plan covers beyond this estimate, the number on your insurance card is the best source.

Please call us at 234-555-0174 and we will help with the payment plan or anything else.

Warmly,
Eli Kirby
Front Desk, Plumford Family Dentistry

Questions for the owner

What is the patient's plan yearly maximum, and should we mention it?
Do you want to include the payment plan terms (amount per month, length) in this reply?

What it does

Writes a clear, kind, honest reply to a patient who has a question about dental insurance, coverage, their estimate, or their bill. It uses only the figures and facts the office has on file, and it says plainly what the office does not know.

Use it when: Use when a dental office needs to reply to a patient's question about insurance, such as "answer this insurance question," "patient asking what their plan covers," "why is my bill higher than expected," or "write back about the estimate."