your last dental appointment, we didn’t get your signature on the dental claim form that will be submitted to your insurance company. Please sign where indicated and return the form in the enclosed envelope or drop it off at our office.
Be sure to return this form immediately so this account will be paid quickly. Thank you for your cooperation and the opportunity to provide you with the best in dental care.
Sincerely,
Dentist and Team
Enclosure
Treatment Beyond Insurance Maximum
Date
Patient Street Address City, State Zip
Dear Patient:
Your insurance company has told us that you have gone over your specified limit for dental benefits for this plan year. We have many payment methods, and would like to help you to find one to cover the cost of your dental treatment. Please contact our office at [office number] to work out the details with [financial coordinator ’s name], our financial coordinator.
If you have any questions about your dental plan coverage, you should contact your employer’s benefits manager or your insurance carrier directly. We look forward to speaking with you soon.
Sincerely,
Dentist and Team
Treatment Beyond Insurance Maximum — CareCredit®
Date
Patient Street Address City, State Zip
Dear Patient:
Your insurance company has told us that you have gone over your specified limit for dental benefits for this plan year, and we would like to help you find a payment method to help cover the cost of your dental treatment.
One payment option is CareCredit®, the credit card just for healthcare.* The enclosed brochure provides you with more complete information. With CareCredit, you’ll enjoy these benefits:
Flexible financing options
No teaser rates or introductory rates
Convenient, low minimum monthly payments
No annual fees or prepayment penalties
Credit decision received immediately
If you have any questions regarding CareCredit patient plans, please call them at 1.800.677.0718 or visit their website at www.carecredit.com. We’ll also be happy to answer your questions if we can, and look forward to seeing you again soon.
Sincerely,
Dentist
Enclosure
* Subject to credit availability/approval
Patient Balance Due After Office Received Insurance Payment
Date
Patient Street Address City, State Zip
Dear Patient:
Thank you for your recent office visit. Our office has received payment from your insurance company for your dental treatment. However, due to the limitations of your dental plan, only a portion of the bill was covered. The balance of your payment is [amount]. According to the agreement you signed before you began treatment, you are responsible for this remaining balance.
Please send this amount to our office as soon as possible. If you have any questions, contact your insurance carrier, your human resources department or our office at [office number]. Again, it is our pleasure to provide you with outstanding dental care.
Sincerely,
Dentist
Query to Insurance Company About Late Payment
Date
Insurance Carrier Street Address City, State Zip Attn: Insurance Carrier Contact
Re: Carrier Group insurance number and branch Patient Policyholder and account number
Dear Name:
On [date], our office submitted a dental claim form for the above patient, [patient name]. A copy of this form and a full description of our treatment are attached. We usually receive reimbursement within [number] weeks, and are concerned that there is a problem.
Please contact our office if you have any questions or problems concerning the processing of our claim. Our office number is [office number]. Thank you in advance for your prompt response to this inquiry.
Sincerely,
Dentist
Enclosure
Date
Patient Address City, State Zip
Dear Patient:
Direct reimbursement is a great alternative to traditional dental insurance. Direct reimbursement is an employer-sponsored plan that can offer you comprehensive dental benefit coverage and the freedom to choose any dentist.
In recent years, corporate belt tightening and insurance companies may have limited your choices when it comes to dental care. When your employer implements direct reimbursement, you visit the dentist of your choice, receive treatment, and arrange for payment. After your appointment, you present a paid receipt or proof of treatment to your employer or plan administrator for reimbursement. In addition, many plans will allow benefits to be assigned directly to the dental office.
This plan reimburses you based on total expenses incurred. There are typically no deductibles and few excluded services. It frees us to determine exactly the care you need for a healthy and long-lasting smile. Direct reimbursement also helps you avoid unpleasant
