Pediatric Dentist in Albany, NY - Dr. Lawrence A. Kotlow

Office Information

How are Appointments Scheduled?

The office attempts to schedule appointments at your convenience and when time is available. We suggest preschool children be seen in the morning because they will  be fresher and we can work more slowly with them for their comfort. School children with a lot of work to be done are usually seen in the morning for the same reason. Dental appointments are an excused absence. Missing school can be kept to a minimum when regular dental care is continued.

Since appointed times are reserved exclusively for each patient we ask that you please notify our office 24 hours in advance of your scheduled appointment time if you are unable to keep your appointment. Another patient, who needs our care, could be scheduled if we have sufficient time to notify them. We realize that unexpected things can happen, but we ask for your assistance in this regard.

What About Finances?

Payment for professional services is due at the time dental treatment is provided. Every effort will be made to provide a treatment plan which fits your timetable and budget, and gives your child the best possible care. We accept cash, personal checks and most major credit cards.

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Our Office Policy Regarding Dental Insurance

We are happy to submit your child's (children) insurance claims. However you are responsible for knowing your benefits and understanding the contract upon which you have chosen for coverage. We will collect from you an estimated amount that the insurance company is not expected to pay at the time of your visit.

If after billing your insurance a balance is still owed you will be billed. Any balance billed not paid within 30 days will incur a fee of 1.5% each month on the unpaid balance.

Please understand that we submit dental insurance as a courtesy to our patients. We do not have a contract with your insurance company, only you do. We are not responsible for how your insurance company handles its claims or for what benefits they pay on a claim. We can only assist you in estimating your portion of the cost of treatment. We at no time guarantee what your insurance will or will not do with each claim. By law your insurance company is required to pay each claim within 30days of receipt. We also can not be responsible for any errors in filing your insurance, if the correct information is not provided. Once again we file claims as a courtesy to you.

Insurance Questions and answers

Question 1: Will my insurance cover 100% Dr. Kotlow's treatment?

Dental insurance is meant to be an aid in receiving dental care. Many patients think that their insurance pays 90%-100% of all dental fees. This is not true! Most plans only pay between 50%-80% of the average total fee. Some pay more, some pay less. The percentage paid is usually determined by how much you or your employer has paid for coverage, or the type of contract your employer has set up with the insurance company.

Question 2 : Who determines what my insurance covers?

You may have noticed that sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist's actual fee. Frequently, insurance companies state that the reimbursement was reduced because your dentist's fee has exceeded the usual, customary, or reasonable fee ("UCR") used by the company.

A statement such as this gives the impression that any fee greater than the amount paid by the insurance company is unreasonable, or well above what most dentists in the area charge for a certain service. This can be very misleading and simply is not accurate.

Insurance companies set their own schedules, and each company uses a different set of fees they consider allowable. These allowable fees may vary widely, because each company collects fee information from claims it processes. The insurance company then takes this data and arbitrarily chooses a level they call the "allowable" UCR Fee. Frequently, this data can be three to five years old and these "allowable" fees are set by the insurance company so they can make a net 20%-30% profit.

Unfortunately, insurance companies imply that your dentist is "overcharging", rather than say that they are "underpaying", or that their benefits are low. In general, the less expensive insurance policy will use a lower usual, customary, or reasonable (UCR) figure.

Question 3 - Do I have a deductible to pay before my insurance pays?

When estimating dental benefits, deductibles and percentages must be considered. First a deductible (paid by you),  is subtracted, IF the plan then pays 80% for this particular procedure. The insurance company will then pay 80% MOST IMPORTANTLY, please keep us informed of any insurance changes such as policy name, insurance company address, or a change of employment.

Question 4 Do you accept GHI, CDPHP and Child Health Plus Insurance ?

At this time we participate and will accept as payment, less any required deductions: GHI and CDPHP, Healthplex and Wellcare Child Health Plus insurance programs. We do not participate in the Medicaid program.

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