"Usual and Customary" fees

What does it mean when the insurance company tells me my dentist’s fee is higher than “usual and customary”?

“Usual and Customary fees” are arrived at by averaging the fees of all of the dentists in a certain geographic area. Regrettably, these fees are evaluated very infrequently, so they are not always a reflection of the current cost of providing care.

In addition, the statement “exceeds usual and customary” also implies that the dentist is overcharging, rather than indicating that the insurance carrier is under-providing. In fact, the extent of your coverage is simply based on how much your employer was willing to spend. If your insurance does not cover the full fee for your visit, it may be that this was the intent… with coverage that is intended to be mediocre, the fees of any high quality dental office might look unreasonable, even if they just keep up with inflation annually.

Our fees are covered fully by any number of carriers. We would be happy to share our knowledge with your benefits coordinator.

In addition, it won't surprise you to find out that a professional office infused with an air of excellence, at every angle, will not be a place with the lowest fees. "Discount rates" may be fine for phone service and paper products, but we worry about that concept when it comes to  healthcare. The kind of place where most of us will want to be cared for would:

·      Have a superb, long-term staff that gives patients the best possible experience.

·      Have state of the art technology creating the best, most painless results for patients.

·      Have an exceptional facility that exemplifies a warm, personalized environment for care. 

In the final analysis, our hope is that you have experienced something unique and pleasantly different in your visit to Fiddlehead Family Dentistry. Our efforts to make your visit comfortable, fun and first-rate are unwavering. We are not a “usual and customary” dental practice… nor do we want to be.