General FAQ

General Questions about our office

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Private Insurance FAQ

General Questions about your private insurance

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Medicaid Insurance FAQ

General questions about your Medicaid Insruance

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General FAQ

Q: What doctors work at the office?
At our Glendale location: Dr.Evanthia Peikidis treats patients on Mondays and Thursdays, Dr.Vincent Bilello is in on Tuesdays, Wednesdays, Fridays and certain Saturdays.
At our Garden City location: Dr.Bilello treats patients on Mondays, Thursdays and certain Saturdays. He is also available any day for any emergencies.

Q: How is an orthodontist different from a general dentist?
Orthodontists attend dental school but then specialize in orthodontics by completing a residency program. They are trained to specifically diagnose, prevent and correct both teeth and jaws that are out of position.

Q: Do I need a referral before scheduling a consultation?
Referrals are not needed, but if your general dentist feels that orthodontic treatment would be needed they usually would refer you to an orthodontist.

Q: How do I know if my child is ready for treatment?
Patients as young as 7 years old sometimes can benefit from limited early interceptive treatment. Usually when there is severe
Children may be candidates for early interceptive orthodontic treatment. In select cases early treatment reduces severe complexity from occurring later down the line. In cases where baby teeth are still present, interceptive treatment such a palatal expander may be recommended for expansion or a headgear to reduce overjet. If your child does not need treatment yet, we will schedule a future recall appointment. Sometimes a referral may be needed for the extraction of baby teeth to help with the eruption of adult teeth.

Q:What types of treatment options are available?
We offer traditional metal braces, ceramic upper braces, gold iconix braces, Invisalign / In-House Aligners, palatal expanders, headgears, removable essix retainers, bonded permanent / fixed retainers.

Q: What will happen at my consultation appointment?
The medical history, smile analysis, and HIPAA forms can be printed out and completed before your appointment time if you’d wish. At the visit an assistant will take some intraoral photographs and do a 3D scan of the teeth. The doctor will answer any questions or concerns you may have regarding the alignment of the teeth or bite, as well as provide a treatment time. Certain cases may need additional records before a treatment time can be determined. If your insurance requires x-rays to submit for an approval, those will be taken as well. If the patient is not ready for any orthodontic treatment at the moment, we will schedule you for a recall appointment.

Q:How do I start treatment?
If after your consultation you want to move forward with treatment, your first appointment will be a records visit. We will update the photos, scan, and x-rays as needed, as well as sign the contract with the payment terms. If the patient has had a checkup and cleaning with a general dentist in the last 6 months, then we can proceed to scheduling the long appointment. This is either an hour visit for a braces bonding or 45 minute visit for attachments. These appointments are only done in the morning and early afternoon.

Q:Do I need retainers after my braces / aligner treatment?
Yes, all patients receive essix retainers once they are finished with treatment. In order to prevent relapse, retainers must be worn as a lifetime commitment. The final records include a 3D scan that is used to print out models of your teeth. These are then used to create your retainers. Even with a fixed retainer, we still instruct our patients to wear the removable retainers nightly.

Q:What if I was told by my dentist that I need teeth taken out?
At your consultation an outcome simulation will be done from the 3D scan, if possible. This will allow the doctor to show the patient how the teeth are aligned, and what may need to be done to bring them there. In some cases extractions may need to be done, but in others space can be created by doing interproximal reduction between the teeth. If extractions are needed we will write you a referral for the general dentist.

Q: Do you take transfer cases?
We do take over cases that were started at a different office, but the old braces must be removed and replaced with our brackets.

Private Insurance: FAQ

Q:What insurances do you accept?
We accept all insurances that have orthodontic benefits. Please keep in mind that there may be additional restrictions such as age limitations even if the insurance says there are orthodontic benefits. Here are some of the insurances we commonly deal with: Delta Dental/DC37, Aetna, Cigna, UFT, PBA, UHC, Blue Cross and Blue Shield Dental, GHI, DDS Dental, Daniel H. Cook, Guardian, Metlife, SIDS/ASO, Seledent and many more.

Q: How do you figure out the maximum orthodontic benefits?
At your visit we have you fill out an ADA form to submit to your insurance for an estimate of benefits (EOB). Whatever benefits are available to you will be subtracted from the fees provided.

Q: How long will it take to hear a response from my insurance?
It varies but typically we will receive the approval in about 4-6 weeks. Once we receive it we will call you to go over the financials. If you’d like to know what your benefits are sooner, you can call your insurance, but we cannot begin until we receive an approval.

Q: I’ve had braces before, will my insurance cover again?
Unlike dental benefits orthodontic benefits do not renew yearly. If the previous treatment used up all of the benefits, then there would be no additional payments from the insurance regardless of where you previously had treatment. If you have a different insurance or plan then you may have benefits available again.

Q: What if I have more than one dental insurance?
If there is more than one plan, there may be limitations to when the benefits can be collected. In some cases one insurance needs to completely finish paying before the second can kick in. As it can take up to 2 years for an insurance to pay, the reimbursement would be provided once the second insurance finishes paying as well.

Q: What if my insurance does not offer orthodontic benefits?
Fees are given based on the type of treatment and the treatment time needed. All out of pocket costs are broken down into a payment plan, split up over whatever the treatment time is. We recommend looking into whether your employer gives the option of opening a Health or Flexible Spending account (HSA/FSA).

Q: What if I lose / gain my dental insurance?
Insurance companies all distribute payments differently. Typically we receive a bulk payment at the start and then monthly payments throughout treatment. Some insurances will do a bulk payment at the start, and another a year in. If you lose your insurance, you become responsible for whatever balance is remaining from the insurance’s portion. If your insurance has an age limitation that you are nearing, they will only pay up until the age limit. If you gain a new insurance at any point in treatment, we can submit and see if there are associate benefits.

Medicaid Insurance: FAQ

Q: Do you accept Insurances with Medicaid?
Yes, Medicaid covers a variety of health services including dental benefits, but there is only orthodontic coverage for those under 21. If you are over 21, we will submit the referral (D8660) but it will be denied.

Q: Do you accept Manage Care Insurances without Medicaid?
Manage Care Insurances only have orthodontic benefits for members with Medicaid under the age of 21. If you do not have Medicaid, then the referral will be denied and no orthodontic coverage is offered.

Q: How long will it take to hear a response from my insurance?
It can take anywhere from 3-5 weeks to receive a response from the insurance.

Q: Does Medicaid pay for treatment in full?
If approved, then Medicaid pays for the traditional metal braces and removable retainers in full, as long as the member remains active with both their insurance and Medicaid. Approval by Medicaid insurances is dependent on how medically necessary a patient scores on the HLD scale. Scores consist of measurements made from the records taken at the appointment. There are also several auto qualifying conditions on the HLD that replace the need for the otherwise required minimum of 26 points.

Q: What types of orthodontic treatment does Medicaid cover for?
For comprehensive treatment they approve for the traditional metal braces, which includes the removable essix retainers at the end of treatment. They may sometimes approve for a second set of replacement retainers as well. They do not approve for permanent/fixed retainers or aligners such as Invisalign. For interceptive (early age) treatment they may approve for a palatal expander.

Q: What if my Medicaid insurance does not offer orthodontic benefits?
For those over the age of 21, fees are provided based on the duration of treatment time needed. All out of pocket costs are broken down into a payment plan, split up over whatever the treatment time is. We recommend looking into whether your employer gives the option of opening a Health or Flexible Spending account (HSA/FSA).

Q: What if I lose my Medicaid Insurance during treatment?
If the patient is not active with their insurance they must let us know immediately. The recertification process can cause a lapse, but if you no longer qualify for Medicaid the remaining balance of the treatment cost would become the patient’s responsibility.

Q: How long does Medicaid cover for?
Depending on which insurance you have (DentaQuest, Liberty BC/BS, Healthplex, UHC) the insurance will approve for D8080 and a certain amount of D8670’s. The D8080 is for the bonding of the braces. Each D8670 is an approval for a quarter (3 months) of treatment. Typically insurances will approve for 8 quarters (2 years) and may only approve for a third year of treatment if they deem is still medically necessary. If they deny to pay for a third year, they will still pay for the debonding and retainers.

Q: What are my options if I receive a denial?
If the patient gets denied for either braces or an expander, the guardian may do an appeal or schedule a Fair Hearing Trial to try and have the insurance reverse their decision. Appeals and Fair Hearing Trials are not submitted or arranged for by the office for patients, the insurance is to be contacted directly. For more information on this click here.

Q: I’ve had braces before, will my insurance cover again?
If you have already had braces with a Medicaid insurance they would not cover for treatment again. If you now have a different Medicaid insurance than the one that paid for treatment, you would only get approved if your teeth have relapsed enough to score high enough on the HLD scale which is uncommon.