Reasonable and Customary

What does it mean?

At times, our fees may be greater than what your insurance company calls “reasonable and customary” and this may result in extra payment from you, the patient. Why is this so?

  • Each insurance company conducts its own surveys to determine its own “reasonable and customary” fees. They keep this information confidential, leaving the public unaware of the inconsistencies of these findings. The fact is that different insurance companies have different “reasonable and customary” fees – often in the same area.
  • All dental plans have different features: deductibles, “reasonable and customary fees,” etc. Better dental plans cover more of your personal costs, but are also more expensive. This is something you or your employer must decide on.
  • Dental plans that have lower “reasonable and customary” fees leave the dentist and the patient in a situation where it looks like the dentist is overcharging the patient. It may be the hope of the insurance company that the dentist will then lower his fees, resulting in the insurance company not having to pay out as much in premiums.
  • Dentists, like other professionals, vary in the quality of care they provide. Dentistry is a rapidly developing field, and education and up-to-date tools are essential for the best care.

We feel that you, the patient, deserve the best care for your teeth. We are constantly improving our knowledge and have up-to-date techniques and equipment. Not only are we “fixing your teeth,” we are educating you on how to keep them as healthy as possible. This may cost a little more than is “reasonable and customary,” but our hope is that you will have healthier teeth that will need less work in the future.

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