Insurance & Financial Policy
Making Dental Care Easy to Understand
At Radiant Dental, we’re committed to providing high-quality care while being transparent about costs. This page outlines our complete financial policies, insurance guidelines, and what you can expect when it comes to payments—so you can feel confident and informed about your dental care.
At Radiant Dental, we believe your dental care should focus on what’s best for your oral health—not just what’s covered by insurance. Our goal is to be upfront about treatment costs and insurance limitations, so there are no surprises.
Financial Policy
Payment Due at Time of Service
Full payment, co-pays, and deductibles are due when treatment is provided.Accepted Forms of Payment
We accept cash, Visa, Mastercard, Discover, and American Express. Financing is available through CareCredit with prior approval.Late Payments & Collections
Accounts unpaid after 90 days may be sent to collections, with additional fees and finance charges (1.5% per month / 18% APR).Missed Appointment Fee
A $100 fee applies to no-shows or cancellations with less than 48 hours’ notice.Changes to Treatment Plans
Treatment may change based on clinical findings; you’re responsible for the cost of services provided.X-rays and Diagnostic Records
You authorize our team to take necessary x-rays, photos, and models for diagnosis and care.
How Dental Insurance Works at Radiant Dental
Dental insurance can be confusing — and plans are often designed that way. Here’s what you need to know:
We Accept Most PPO Plans
We are in-network with a few plans, but we accept most PPO insurances and will gladly file claims on your behalf. That said, you are ultimately responsible for the full cost of treatment regardless of what your plan covers or denies.
We Bill Your Insurance as a Courtesy
While we’re happy to help, your plan is a contract between you, your employer, and the insurance company — not with us. We assist with verification and filing, but we don’t control coverage decisions. You are ultimately responsible for the full cost of treatment.Insurance Estimates Are Not Guarantees
We do our best to provide an accurate estimate based on the information available to us at the time. However, those estimates are based on limited data provided by your insurance company, which often does not include full plan details, prior treatment history, or all coverage limitations.
Even when we receive a pre-authorization, most insurance companies include disclaimers stating that it’s not a guarantee of payment. Policies, coverage levels, and allowable amounts can change at any time — and we often don’t discover these changes until after the claim has been submitted and processed.
Because of this, you may owe more than originally estimated, especially if your insurance denies a portion of the claim due to prior history, frequency limitations, alternate benefits, or other restrictions we couldn’t verify in advance.
You May Owe More Than Expected
Even if a service says “100% covered,” that usually means 100% of the insurance’s allowed fee—not our full fee. A balance may still apply.Common Insurance Limitations Include:
Annual maximums
Waiting periods
Frequency limits on exams, cleanings, or x-rays
Alternate benefits (e.g., downgrading a crown to a filling)
Denials for work done at another office
Missing Tooth Clause
Important Note on Major Services
Insurance companies often deny or reduce coverage on major treatments like:
Bone grafts
Because of this, payment is due upfront for these services. We will still file your claim, and if your insurance reimburses any amount, we’ll refund or credit you accordingly.
Your Responsibilities
We’re happy to assist in understanding your benefits, but it’s your responsibility to:
Know your insurance coverage, deductible, and yearly maximum
Be aware of any limits, waiting periods, or exclusions
Follow up with your insurance if needed
Questions? Need Help?
Contact us at 770-271-4411 or email us. We’re here to help you every step of the way.
⚠️ Why We Require Payment Up Front (Even If You Have Insurance)
We want to be honest with you about why we sometimes collect full payment in advance—especially for major procedures.
Most dental insurance plans are not designed to fully cover care, especially when it comes to crowns, bridges, root canals, implants, or other major services. Here’s what you should know:
Your plan is based on how much your employer chose to pay into it — not your actual dental needs.
Insurance companies rarely provide us with full or reliable benefit details.
Even pre-authorizations are marked as estimates, not guarantees.
There are often hidden clauses (like alternate benefits, frequency limits, or prior work exclusions) that only show up after the claim is processed.
When insurance pays less than expected or denies a claim, you’re responsible for the remaining balance.
We do everything we can to help you use your benefits—but we can’t make insurance companies pay more than they want to. That’s why we collect upfront and refund or credit you if insurance does pay later.
Thank you for understanding that we’re on your side, and we’re here to help—not to cause billing headaches.
🧾 What You Should Know About Out-of-Network Coverage
Some patients are surprised to learn that we’re not in-network with their specific plan. But what most insurance companies don’t explain is that for PPO plans, the difference in coverage is often minimal — especially for basic and major procedures. The bigger issue is that dental insurance is limited by design.
Most PPO dental plans cover out-of-network care at nearly the same rate as in-network, particularly for common services like cleanings, exams, fillings, and crowns.
That’s because dental insurance isn’t like medical insurance — it’s more like a limited-use discount plan. The true limitations often come from your plan’s structure, not your provider:
Annual maximums typically cap coverage at $1,000–$1,500 per year
Frequency limits and waiting periods can apply, regardless of network
Alternate benefit clauses may reduce coverage for major work
Reimbursement amounts are often based on UCR (usual, customary & reasonable) fees in our area. However, some insurance companies pay based on significantly lower internal fee schedules. We find this practice misleading and unfair, but unfortunately, there are no regulations in place to prevent it. What’s more, insurance companies often refuse to share their allowed amounts with us—leaving us with no way of knowing what they’ll pay until after we’ve provided treatment and submitted the claim.
In fact, your employer selects the plan’s coverage level and limitations, which are often based on cost — not quality of care or provider choice.
So if you need real dental work — crowns, root canals, implants, etc. — you’ll likely max out your plan quickly, regardless of network status.
What matters most is choosing a dentist you trust to give you the right care — not the one your insurance happens to reimburse slightly differently.
We work with most PPO plans and will help you file claims, maximize your benefits, and receive reimbursement when eligible. But the choice of provider is always yours, and we’re here to deliver the best care with full transparency.
Frequently Asked Questions (FAQs)
Why do I have to pay at the time of service?
Insurance is a contract between you and your insurer—not with us. We collect payment upfront to avoid confusion since insurance coverage isn’t guaranteed and estimates can change after claims are processed.
What if my insurance doesn’t pay the full amount?
You’re responsible for any balance your insurance doesn’t cover. We’ll help you file claims and can refund or credit you if your insurance reimburses us later.
Why are some major treatments paid upfront?
Insurance often limits or denies coverage for major services like crowns and implants. Collecting payment upfront helps prevent surprise bills.
I’m out-of-network. Will my insurance still cover treatment?
Most PPO plans offer similar coverage for out-of-network care as in-network, especially for basic and major services. We’ll help you maximize your benefits regardless of network status.
How can I find out what my insurance covers?
Call your insurance provider or give us a call. We’re happy to help review your benefits and explain your coverage.
Questions? Need Help?
Have questions about your plan or what your insurance may cover?
📞 Call us at 770-271-4411
Our team is here to help you navigate your benefits with clarity and confidence.
© Radiant Dental | Serving Buford, GA | Contact Us
🧾 What You Should Know About Out-of-Network Coverage
Some patients are surprised to learn that we’re not in-network with their specific plan. But what most insurance companies don’t explain is that for PPO plans, the difference in coverage is often minimal—especially when it comes to basic and major procedures. The bigger issue is that dental insurance is limited by design:
Most PPO dental plans cover out-of-network care at nearly the same rate as in-network—especially for basic and major services.
That’s because dental insurance is not like medical insurance. It’s more like a limited-use discount plan with small annual maximums, frequency restrictions, and exclusions. The biggest issue usually isn’t whether your dentist is in-network — it’s that most dental plans only cover $1,000 to $1,500 per year, no matter where you go. Your employer chooses the coverage level based on cost—not patient care.
So if you need real dental work — crowns, root canals, implants, etc. — you’ll likely max out your plan quickly, regardless of network status.
What matters most is choosing a dentist you trust to give you the right care — not the one your insurance company happens to reimburse slightly differently.
We work with most PPO plans and will help you file claims, maximize your benefits, and even receive reimbursement when eligible. But the choice of provider is always yours, and we’re here to give you quality care with full transparency.
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| Mon, Wed | 8:30 AM – 5:00 PM |
| Tue, Thurs | 11:00 AM – 7:00 PM |
| Saturday | 8:00 AM – 2:00 PM |
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