Insurance, Billing & Financial Policies
Insurance and Billing
At Colorado TMJ & Facial Pain, we strive to make the insurance and billing process as clear and straightforward as possible. As an orofacial pain specialty practice, we submit claims to medical insurance plans for eligible services.
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Participating Insurance Plans
We are currently in network with:
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Aetna
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Anthem Blue Cross Blue Shield and participating out-of-state Blue Cross Blue Shield plans
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Kaiser Permanente PPO
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Coming Soon
We will be in network with United Healthcare beginning December 1, 2026.
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Medicare & Medicaid
We are a Medicare Part B non-participating provider.
We are not currently in network with Health First Colorado, Colorado’s Medicaid program.
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Coverage & Payment Information
Coverage depends on your individual insurance plan, diagnosis, and services provided. Some TMJ, orofacial pain, headache, and sleep-related services may not be covered by your insurance.
Our team can verify your benefits and provide an estimate of your expected responsibility before treatment. However, verification of benefits is not a guarantee of coverage or payment. Final coverage is determined by your insurance company after the claim has been reviewed and processed.
Copays, deductibles, coinsurance, and charges for non-covered services are the patient’s responsibility. Payment is due at the time of service.
Please contact our office if you have questions about your insurance plan, estimated costs, claims, or payment options.
Financial Policies
Insurance Billing & Financial Responsibility
Colorado TMJ & Facial Pain will submit claims to your medical insurance on your behalf.
Because insurance benefits and reimbursement vary by plan, coverage and payment are not guaranteed. Patients are ultimately responsible for any portion not paid by insurance, including deductibles, copays, coinsurance, and non-covered amounts.
All services are billed at our standard office fees unless an applicable in-network insurance contract requires otherwise.
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Non-Covered Services
Any service not covered by your insurance plan is the patient’s responsibility and payment is due in full at the time of service.
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Payment & Outstanding Balances
Payment is due at the time of treatment unless prior financial arrangements or an approved financing plan have been made.
Any remaining balance must be paid within 30 days of the date of service. Patients with an outstanding balance will receive a courtesy text message and phone call reminder.
Insurance Payments & Refunds
In some cases, insurance may send payment directly to our office after you have already paid for services. If this results in a confirmed credit balance after the insurance claim has been finalized, a refund check will be processed within 3–5 business days and mailed to the address on file.
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