Insurance Information

At Stone Ridge Oral & Facial Surgery we make every effort to provide you with the finest care and the most convenient financial options. To accomplish this, we work hand-in-hand with you to maximize your insurance reimbursement for covered procedures. If you have any problems or questions, please ask our staff. They are well informed and here to assist you. They can be reached by phone at Gum Spring Library Building Phone Number 703-327-5655.

We currently accept the following PPO’s

Aetna, Alliance, Ameritas, Anthem (Blue Cross/Blue Shield), Carefirst (Blue Cross/Blue Shield), Cigna (dental), Coventry (foreign benefits services), Delta, DenteMax, Dominion (PPO), Geha, Guardian, Humana, MetLife, United Healthcare (dental), United Concordia and many more.

Please call if you have any questions or concerns regarding your initial visit.

Please bring your insurance information (Medical and Dental) to your first office visit so that we can expedite reimbursement.

  While the thought of surgery can be overwhelming, navigating through the insurance industry can sometimes feel even more difficult. It is our hope that the information below may help clarify some questions regarding coverage. Please take the time to review the following as it contains important information pertaining to your insurance coverage and financial obligations…

IS DENTAL “INSURANCE” REALLY INSURANCE?

  • Dental “insurance” is not quite insurance in the traditional sense. If you crash your car, you may be responsible for the first $XXX (deductible) and your insurance will cover the rest of the repairs. Dental “insurance” differs in that in addition to having a deductible, you likely will have “co-insurance” obligations, which means you are responsible for a percentage of the procedure, in addition to your copayment and/or deductible. Most importantly, dental policies have a “annual maximum benefit” which means once you’ve exceeded the annual maximum benefit for the policy year, you are responsible for ANY balance in excess of your annual maximum benefit.

PRE-DETERMINATION OF BENEFITS

  • We routinely send a “pre-determination of benefits” request to your insurance carrier on your behalf. This is sent (electronically if your plan has the capability) on the day of your evaluation and may take several weeks to receive a response. An “Explanation of Benefits” will be mailed directly to you from your insurance carrier. It is crucial to remember that your patient share is an ESTIMATE supplied by your insurance company. Insurance companies will not give a guarantee of benefits or payments. Benefits are subject to review once they have received your claim. Also, if you receive ANY dental service from ANY provider between the time your predetermination request is sent and the day of surgery, your benefits will change and you will likely exceed your “annual maximum benefit” mentioned above. We encourage patients to contact their insurance company if they have questions regarding their benefits. Ultimately, you are responsible for all financial obligations for your treatment and your estimated patient share is due the day of surgery.  We are required, by your insurance carrier, to collect this amount in full.
  • On many occasions, if you are unable to wait for a “pre-determination request” from your insurance carrier, you can still be seen for surgery but we will collect 50% of your insurance carrier’s contracted fees on the day of surgery. After your insurance carrier processes the claim according to the terms of your policy contract, you will receive a refund or a statement based on your “Explanation of Benefits” received from your insurance carrier.

NON-COVERED SERVICES

  • As a Board Certified Oral & Maxillofacial Surgeon, Dr. Armanious provides a wide range of surgical procedures for our patients. Unfortunately not every procedure is a covered benefit under your insurance plan. Dr. Armanious may have recommended a procedure or a radiological study that is deemed necessary for your care, but your insurance carrier may consider it as an elective procedure if it is not covered. If you have elected to have a non-covered procedure performed, you will be responsible for the payment in full. We will gladly discuss with you any questions regarding your insurance coverage. Please note, dental insurance companies are prohibited from establishing fees and/or allowable amounts for procedures which the insurance company has determined to be non-covered procedures for dental and/or oral surgery performed in the Commonwealth of Virginia. (Effective 07/01/2010)

We understand that life is full of unexpected surprises. If you must cancel an appointment, we kindly ask for a 24 hour notice so that we may offer the time to another patient who may be on our wait list. Failure to provide our practice with a 24 hour notice will result in a $45 cancellation fee that will be required in order to reserve a future appointment slot.