Insurance Information

Important: Oral surgeons are considered dental as well as medical specialists.

What does it mean: oral surgery benefits are often separated from your regular dental benefits.  “Coordination of benefits” among your dental and medical carriers are common.  Please provide ALL of your dental and medical insurance information in order to avoid any confusion or mistakes.  Your medical specialist copay may apply with certain procedures and insurance coverage.

With “coordination of benefits”, insurance carriers which carry your plans will decide whether or how your procedure may get covered.  Therefore, longer processing time may result.  If you have seen your dentist recently or is planning to see your dentist soon, your maximum may be affected.  Please note that insurance coverage does not guarantee payment and may deny claims nevertheless. Please note that if you have multiple insurance carriers, fee schedule may vary among the carriers.  It also does not mean you are necessarily 100% covered for your oral surgery procedure just because you have multiple insurance.

At Prospect Oral Surgery Center 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 Monroe Township Office Phone Number 609-860-6369.

Due to the nature of coordination of benefits for most oral surgery procedures, your insurance carriers may decide to cover for part of your procedure. Since different insurance carriers have different fee schedules, it is not always possible for us to give you a treatment estimate prior to your first visit.  An estimate will be rendered after the initial visit.  After your Explanation of Benefits (EOB) is finalized, you may or may not be subjected to the remaining balance, which may differ from your original copay estimate.  We understand this may be confusing to anyone and we are here to help.  You are given a copy of our office’s Financial Policy.  Please refer to the policy for more details.

** Please note that we no longer accept NJ Health/Family Care (Medicaid), Aetna DMO and Cigna PPO. Please check with your insurance carrier for the providers most convenient to you should you decide to stay within your network. We will be happy to see you as an out-of-network provider at our office fee if you choose to do so.

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

Please note that Medicare does not cover oral surgery procedures.

List of insurance carriers that we currently accept (Dental and Medical):

  • Aetna Dental: PPO, Medicare Advantage and discount plan
  • Aetna Medical
  • Assurant Dental
  • Ameritas Group
  • Anthem Dental
  • American National Dental Service (Discount Plan)
  • AVS Dental Plan
  • Ameriplan (Discount plan)
  • Benecare: Select, Plus, Choice, and Operating Engineers Plan
  • Connection Dental
  • Delta Dental, Delta Care USA
  • Dentegra
  • Dental Call
  • Dentemax
  • Dearborn National
  • DHA
  • Empire BCBS: FFS, DCN, PCN, 3TN-spec
  • Fidelio
  • GHI Preferred plus
  • Guardian PPO, DHMO
  • Healthplex Dental: PPO, Capdent
  • Horizon Dental: PPO, DHMO, Centurion
  • Horizon Medical PPO, managed care
  • Humana
  • Logistics Health (LHI) army reserve
  • Maverest Dental
  • North East Dental
  • Oxford Medical
  • Principle Financial
  • Qualcare medical (selected plans only)
  • Solstice Dental
  • Sunlife Dental
  • Tricare/United Concordia
  • United Health Care dental and medical (DBP)