Insurance

We attempt to deliver the finest care at the most reasonable cost to our patients, therefore:

We work hand-in-hand with you to maximize your insurance reimbursement for covered procedures.  Unfortunately, insurance companies usually make money by paying for the least expensive alternative, often disregarding what is in the patient’s best interest!  Very frequently, they will ignore our diagnosis, which utilizes x-rays and a thorough clinical exam, to decrease the benefit and increase their profits.  We refuse to compromise, in any way, our quality of patient care.  For this reason, Dr. Gallagher is not a contracted provider of any insurance company.

We will provide you with an estimate of cost, before treatment is provided, so that you may determine coverage based on your insurance policy. If requested, we can submit a pre-determination of benefits to your insurance company before your surgery to determine your coverage for the service.

As a courtesy we will gladly submit the necessary and appropriate forms to your primary insurance carrier for your reimbursement. When the insurance company sends payment for your claim, our bookkeeper will send you a refund check on the same day.

TriCare/Medicare (Opt-Out):

Patients are required to submit TriCare claim(s), our office does not submit claim(s), nor do we accept TriCare referrals. 

Medicare patients agree to be responsible for payment in full for the services provided here in our office and they acknowledge that the doctor will not submit a Medicare claim (nor will they) and that no Medicare reimbursement will be provided.

(Medicare patients are required to sign an opt-out form stating they agree and understand)

We DO NOT accept Medicaid.

Please remember:

• Your insurance policy is a contract between you and your employer or other entity. Therefore, it’s your responsibility to understand your policy limits, deductibles, scope of coverage, rules and restrictions.
• It is the patients’ responsibility to insure that any and all required and valid authorization(s) and/or referrals have been received prior to your initial consultation and/or surgery.  Please contact your insurance company to determine if this is an essential step stated in your benefit plan prior to coming into our office.  Unfortunately we do not handle appeals.  However, we will provide you with the necessary items to submit to your insurance company.

Insurance is considered a method of reimbursing the patient for fees paid to the doctor and is not a substitute for payment.  Some companies pay fixed allowances for certain procedures, others may apply a percentage of the charge, and some have no benefits for many treatments. Your insurance benefits are described to you in your insurance policy handbook (usually available from your employer).  We will be happy to help you with your insurance matters.  We communicate with insurance companies’ every day and we will do our best to help you receive the optimal benefit from your insurance company.  Please remember that you are fully responsible for all fees charged by this office regardless of your level of insurance coverage.

Please bring your medical and dental insurance card to your consultation appointment!