What is the “usual and customary” fee the insurance company mentions?
The “usual and customary” fee is determined by the insurance companies and every insurance company has a different allowable fee for any given procedure. Your dentist must calculate his or her fees to be reasonable based on their cost. the fees your insurance company pays are the contract established between you and the insurance company. When your insurance states they cover 50%, 80%, and 100% of procedures, this usually does not translate into exactly those percentages because of the “usual and customary” fee determined. We will be happy to give you the codes for the procedures to be performed so that you may contact your insurance company to determine the rate they will pay. If you have any further questions on this matter, please use the form below.
