At Oral & Facial Surgery Center of Tallahassee, we make every effort to provide you with the best surgical 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. Additionally, if your insurance company requires that our services are pre-authorized, we will work with you to obtain such authorization in advance. However, as the insured member, you are ultimately responsible for ensuring that, prior to each visit, you have the required authorizations from your insurance carrier on file with our office.

We are participating providers for the following medical and dental insurance plans

Medical:                                                Dental:
        BlueCross & BlueShield                           Aetna
        Capital Health Plan                                  Ameritas PPO Only
        United Healthcare                                    Assurant PPO Only
                                                                         CIGNA
                                                                         CompBenefits/Humana/American Dental Plan
                                                                         Delta Dental
                                                                         DenteMax
                                                                         Florida Combined Life PPO Only
                                                                         Guardian
                                                                         Humana (Select Plans)
                                                                         Lincoln Financial
                                                                         MetLife
                                                                         Principal Financial Group
                                                                         Reliance Standard
                                                                         Solstice Plans
                                                                         The Standard
                                                                         Tricare
                                                                         United Concordia
                                                                         United Healthcare
 
 

As a courtesy to our patients, our office will file the insurance claim for our patients and will assist you in obtaining your maximum level of benefits from your insurance company. As most of the services we perform in our office are deemed both medical and dental by many insurance companies, it is important that you provide our office with detailed information regarding the primary insurance policies prior to the time services are rendered.

Once insurance has processed your claim(s), you will receive a statement for any balance not paid by the insurance or a refund check for overpayment. Most insurance companies will respond to our request for payment within four to six weeks. As the insured member, you may be asked to assist us in obtaining payment from your insurance company if no response has been received within 30 days. In addition, after 45 days of filing your claim, if the insurance company has not issued payment for your claim, the balance on your account will become solely your responsibility. We kindly ask that you remit additional payments promptly.

Orthognathic patients, you (the patient/insured member) are required to:

  1. Know whether or not your medical insurance requires a referral to a specialist.
  2. Obtain that referral BEFORE you are scheduled to see Dr. Tolley.
  3. Take time to call your insurance company to ask specifically about the doctor you wish to see and your covered benefits.
  4. Referrals typically have an expiration date and limited number of visits so you should carefully monitor the dates and number of visits.

HMO patients – If you expect your services to be covered by your medical insurance (biopsies, tumors, jaw deformities), you MUST have a referral from you primary care physician (“PCP”). A referral from a dentist is not adequate for medical insurance coverage. Obtaining a PCP referral is the patient’s responsibility. If you do not provide a referral, your insurance company will likely deny coverage and you will be responsible for payment of the charges.