Financial Policy at Open Sesame Kids
At Open Sesame Kids, We believe the very best oral health care should be available to everyone, We are committed to making high-quality dental services accessible and affordable for all families. Our goal is to provide comprehensive care that fits within your budget, so you never have to choose between your child’s oral health and your financial well-being.
Our Financial Policy & Available Options
We believe that financial transparency is key to building trust with our patients and their families. That’s why we are dedicated to offering clear, straightforward financial policies that are easy to understand. We make it a priority to discuss costs, payment options, and insurance coverage with you upfront, so there are no surprises along the way.
By working together, we can ensure that your child’s dental care is both effective and financially manageable. Please read through our policy below and familiarise yourself before booking an appointment or visiting our dental practice.
We do work with most employer provided insurance plans as a non-participating out of network provider. Call today for more information.
What insurance policies do we not accept:
We DO NOT accept Medicaid/ Healthfirst.
We DO NOT accept HMO or DMO insurance
Cash patients with a first-time appointment which includes Prophy, Fluoride and Exams will need to be paid upfront.
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. At no time do we guarantee what your insurance will or will not do with each claim. We also can not be responsible for any errors in filing your insurance.
We currently do NOT accept the following Insurance Claims Providers
- Medicaid
- Healthfirst
Our aim is to make your kids dental visit as stress-free, quick and seamless as possible.
Before your child’s appointment, and at our discretion, we recommend that you verify your dental insurance coverage to ensure a smooth and efficient visit. It’s important to confirm your benefits and notify understand if any co-pays, deductibles, or out-of-pocket expenses that apply.
To help expedite this process, we also recommend that you provide us with your insurance information when scheduling the appointment.
This will help avoid any surprises on the day of the visit and ensure that your child receives the best care possible.
Please note: We do not have specific information on Insurance provider coverage as each persons policy can vary significantly and any policy information, claims and benefits are not accessible by us, and must be confirmed by the patient / patients parents prior to treatment.
If we have received all of your insurance information on the day of the appointment, we will be happy to file your claim for you. You must be familiar with your insurance benefits, as we will collect from you the estimated amount insurance is not expected to pay. By law your insurance company is required to pay each claim within 30 days of receipt.
As a courtesy to our patients, we will electronically submit all dental insurance claims so they can easily be processed. We will work with your benefit administrator to estimate and maximize the amount of services your employer has chosen for you. Our dental practice cannot render services on the assumption that the resulting charges will be covered by insurance. Please understand that the parent/guardian bringing the child to our practice is legally responsible for payment of all charges. With regard to billing, it is our policy not to mail statements. We appreciate your understanding and for your convenience, we accept cash, checks and all major credit cards.
We Accept the following payment methods:
1. Cash/Zelle
2. Credit Cards
3 Debit Cards
4. HSA
Navigating dental care costs can be complex, but we are dedicated to offering straightforward and flexible financial options for your family. Whether it is understanding insurance benefits or exploring payment alternatives, our aim is to make the process clear and convenient for you.
Recognizing the needs of families without insurance benefits, we are proud to offer our Smile Assurance Plan. This in-house plan is tailored to make pediatric dental care in New York City, NY, more affordable, allowing you to manage dental expenses while ensuring your child receives essential dental care.
To find out more about this policy, please contact our head office.
*Last Updated August 2024
Our Dental Office Policy
We understand that sometimes life gets busy, and appointments can be missed. However, missed appointments without prior notice can disrupt our schedule and limit our ability to serve other patients. If you miss an appointment without providing at least 24 hours’ notice, a missed appointment fee may be applied to your account. To avoid this, we kindly ask that you inform us as soon as possible if you need to reschedule or cancel. This courtesy allows us to offer the time to another patient in need.
We strive to accommodate all our patients’ scheduling needs and ask for your cooperation in keeping your appointments. If you need to cancel or reschedule an appointment, please provide us with at least 24 hours’ notice. This allows us to offer the time slot to another patient. Cancellations made with less than 24 hours’ notice may incur a cancellation fee. We appreciate your understanding and commitment to ensuring that all our patients receive timely and effective care.
We understand that unexpected situations can arise, and you may need to reschedule your child’s appointment. If you need to make a change, we kindly ask that you contact our office as soon as possible, ideally at least 24 hours before the scheduled time.
This advance notice allows us to adjust our schedule and offer the appointment slot to another patient in need. We will do our best to accommodate your preferred new time and ensure your child’s care continues without interruption.
We highly recommend ringing our office, when looking to re-schedule an appointment.
Phone: 212-874-1200
Email: receptionist@opensesamekids.com
Phone: 212-874-1200
We understand that navigating dental costs and insurance coverage can be complex. That’s why we offer personalized financial consultations to help you understand your options and make informed decisions about your child’s dental care.
Our team can help to review your insurance benefits, discuss any out-of-pocket expenses, and explore flexible payment plans tailored to your needs.
We are committed to working with you to ensure that your child receives the best care while staying within your budget.
If you have any questions regarding treatment costs, financing, or getting estimates on your child’s dental care, please reach out to us.
Please Note: Due to a high volume of patient requests every week, offering personalised financial dental consultations are offered on a first-come first-serve basis, with a limited number available each week, there may also be a several day delay before we get to your request, but we strive to get back in touch with customers within 3 working days.
At our practice, we are dedicated to providing exceptional dental care tailored specifically for children. We understand that every child is unique, and we strive to create a comfortable, positive experience that sets the foundation for a lifetime of healthy smiles.
Our team is committed to using the latest techniques and child-friendly approaches to ensure your child’s visits are not only effective but also enjoyable. We are here to support your child’s oral health journey with compassion, expertise, and a genuine commitment to their well-being.
Our chief dentist, Dr. Grady prioritizes time to get to know each patient and parent on an individual level. We know how valuable your time is. That is why we do not shuffle you between assistants, hygienists, or doctors with wait times and a doctor who only comes in for a few minutes. This one-on-one approach allows for a deeper understanding of your child’s needs, ensuring continuity and personalized attention.
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.
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.
When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume the fee for service is $150.00. Assuming that the insurance company allows $150.00 as its usual and customary (UCR) fee, we can figure out what benefits will be paid. First a deductible (paid by you), on average $50, is subtracted, leaving $100.00. The plan then pays 80% for this particular procedure. The insurance company will then pay 80% of $100.00, or $80.00. Out of a $150.00 fee they will pay an estimated $80.00 leaving a remaining portion of $70.00 (to be paid by the patient). Of course, if the UCR is less than $150.00 or your plan pays only at 50% then the insurance benefits will also be significantly less.
MOST IMPORTANTLY, please keep us informed of any insurance changes such as policy name, insurance company address, or a change of employment.
*Last Updated August 2024
Book Early to secure your appointment - Limited Availability Every Week
Secure your child’s dental care by booking early! With limited availability every week, scheduling ahead ensures your little one receives timely attention from our experienced team. Don’t delay – reserve your appointment today to guarantee prompt and personalized care for your child’s dental needs.
