Financial Information

Starting January 1, 2025, we no longer participate in any medical insurance networks. Delta Dental is the only insurance company that our office will/can submit claims to. Even if your insurance company states that Dr. Kline is in network, this is no longer the case. We will NOT submit insurance claims to those other insurance companies.  However, as a courtesy, we can help you by providing you with an itemized treatment plan and answer any questions you may have about the self-filing claim process. As of 2024, most private insurance companies have their own online portals. 

We do not obtain prior authorizations for consultation and procedures done on the same day. Delta Dental does not require them. If your plan states a prior authorization needs to be done; you may be responsible for submitting a prior authorization yourself, or you may need to reach out to the provider that referred you to Dr. Kline and ask them to submit the prior authorization to your insurance company. In those cases, you may need to come in for a consultation and imaging first. You will likely need to submit these to your insurance as well. 

At the time for surgery, Dr. Kline will determine the exact treatment performed. Once the procedure is complete, we can provide you with the itemized treatment plan. You will need this to file your claim with your insurance company. Please let us know on the day of the procedure that you need this treatment plan printed. If you forget, you can email us at insurance@cworalfacialsurgery.com and request it.  

Once you receive the treatment plan print out, you will need to go to your insurance companies’ website and search for self-filing claim forms. If you are unable to locate this, you will need to call your insurance company to obtain that form and information on how they require you to submit. Some forms require Dr. Kline’s signature, if that is needed, please email the completely filled out form to insurance@cworalfacialsurgery.com and we will get that signed for you. We will then email it back to you. 

Again, starting January 1, 2025; our practice will no longer be contracted with any medical insurance company. We will no longer submit to any medical insurance company and you as the patient or guarantor will be responsible for doing so. This will also include any prior authorizations with any insurance company. Our office will require full payment due at time of check-in for any consultations or procedures. As mentioned above, after the procedure has been completed, you can request an itemized treatment plan to be printed out. This can then be used to file an insurance claim directly through your insurance company.

Steps to Submit a Claim to Your Insurance Company 

Step 1: Understand Your Insurance Coverage 

  • Review Your Policy: Before your visit, review your insurance policy to understand what services are covered, whether out-of-network providers are reimbursed, and any pre-authorization requirements. This will help you know what to expect regarding reimbursement.

  • Know Your Deductible: Be aware of your deductible and co-pay requirements. Insurance companies typically reimburse after the deductible has been met.

Step 2: Receive Services and Pay for Your Visit 

  • Payment at Time of Service: When you receive care from our practice, you must pay for services when they are provided.

  • Request an Itemized Receipt: After your visit, we will provide you with an itemized receipt or a "superbill." This document will include details of the services provided, the costs, and the necessary medical codes (such as CPT codes) that your insurance company requires for processing claims. 

Step 3: File Your Claim with Your Insurance Company 

  • Obtain a Claim Form: You can obtain a claim form from your insurance company's website or by contacting their customer service department.

  • Complete the Claim Form: Fill out the claim form with the required information. This includes details about the services you received, our provider information, and the payment you made.

  • Attach the Itemized Receipt: Include the itemized receipt or superbill we provided you with your completed claim form. Ensure all relevant information, such as service dates, provider details, and diagnostic codes, is included.

  • Submit the Claim: Submit your completed claim form and supporting documents to your insurance company. This can usually be done online, by mail, or via fax, depending on your insurer’s process.

Step 4: Monitor Your Claim 

  • Check Claim Status: After submitting your claim, monitor its status through your insurance company’s website or by contacting their customer service. Keep copies of all documents submitted for your records.

  • Reimbursement: If your claim is approved, your insurance company will reimburse you according to your policy’s terms, such as the out-of-network rate or after your deductible is met.

**Additional Tips** 

  • Pre-Authorization: If you anticipate needing expensive or specialized services, we recommend checking with your insurance company beforehand to see if pre-authorization is required. This can help ensure that your claim will be covered.

  • Appeals: If your claim is denied, review the denial reason and consider filing an appeal if you believe the service should be covered by your insurance.

We hope this information helps clarify the process. If you have any questions or need more assistance, please contact our office. We are here to help you navigate your healthcare needs.