Join the Killingly Dental Care Membership Program
Save thousands of dollars a year with our Dental Membership Savings Plan - A perfect solution for individuals and families without dental insurance.
Our Savings Program is designed to provide greater access to quality dental care at an affordable price.
It's a discounted fee schedule for dental services provided at our office.
PERIODONTAL PATIENT PLAN WILL INCLUDE AT 100% COVERAGE:
Determined by clinical examination, or if patient has received previous periodontal treatment and is aware of existing disease. Loss of attachment, recession, inflammation, bleeding, and pocketing of 5mm or more bone and bone loss.
- Professional Perio Dental Cleanings (up to 3-4 per year)
- Doctor Exams (up to 2 per year)
- Routine X-Rays
- Emergency Exam (1 per year if needed)
- 20% off scaling and root planing with gingival irrigation
- 15% savings on other services/procedures (some exclusions apply)
- 10% savings on Orthodontic Treatment (some exclusions apply)
- See Benefits Details for more details on inclusions.
Plus many other benefits such as:
- NO Yearly Maximums
- NO Deductibles
- NO Claim Forms
- NO Preexisting Condition Limitations
- NO Waiting Periods
- NO Preauthorization Requirements
This is a discount program, not a dental insurance plan.
Please Note: Purchase of this plan does not make you an appointment.
How to Use
To use your Member Exclusive discount for restorative, elective or cosmetic treatment, simply schedule an appointment with our office and be sure to tell us you're a member.
You may schedule online through our website KillingyDentalCare.com by clicking "book now" or call us at 860-779-1053.
When you arrive, we'll make sure your membership is "current" and you will be eligible for instant savings off our regular fees. Your membership activates immediately and is ready for use!
To check on your membership plan status or change payment information login to your Account. To cancel prior to renewal or add/remove members please open a customer support ticket or call our office at 860-779-1053.
PERIODONTAL PATIENT PLAN BENEFITS DETAILS
Inclusion Codes & Details
Perio Cleaning:
- D4910 Periodontal Maintenance Cleaning (Periodontal maintenance is for patients with periodontal disease. It may also be for those who had a periodontal procedure such as a gum graft. This type of cleaning is deeper, targeting periodontal pockets. Gum maintenance removes tartar and plaque from the space between gums and teeth which prevents further bone loss)
- D0180 Complete periodontal charting with doctor assessment of gum and bone health
- D1310 Nutritional counseling
- Caries Risk Assessments:
- D0601 for Low Caries Risk
- D0602 for Moderate Caries Risk
- D0603 for High Risk Assessment
- D1330 Oral hygiene instructions for home care including tooth brushing technique, flossing, and use of special oral hygiene aids.
Doctor Dental Exam:
- D0180 Comprehensive Periodontal Evaluation for a new or established patient and this procedure is indicated for patients showing signs or symptoms of periodontal disease and for patients with risk factors such as smoking or diabetes
- D0120 Periodic Exam by the doctor which is a thorough extra-oral exam and intra-oral exam to include an Oral Cancer Screening and TMJ/occlusion evaluation
- D0150 Comprehensive Exam by the doctor which is a thorough extra-oral exam and intra-oral exam to include an Oral Cancer Screening and TMJ/occlusion evaluation (more extensive evaluations than a periodic examination including reading of a full mouth series of radiographs or a full panoramic image)
Routine Xrays:
- D0274 Bitewing images
- D0220/ D0230 Single tooth periapical images
- D0330 Panoramic image
- D0210 Intraoral Full Mouth Series of Images
- Exclusions: 3D imaging is excluded, see Exclusions & Exceptions
Emergency Visit:
- D0140 Limited Examination
- D0460 Pulp Vitality Testing
- D0170 Limited Re-evaluation
- D0220/D0230 Needed periapical Images (single tooth XRAYs)
Please Note: Additional radiographs may be recommended by your doctor in order to properly diagnose your emergency and may not be covered, these additional radiographs will fall under treatment at 15% savings. Any dental treatment diagnosed during the "emergency exam" that is completed or scheduled is excluded and will fall under the 15% savings plan even if treatment is completed during the emergency visit itself.
20% off Scaling and Root Planing (SRP):
- Codes D4341 and D4342 "Deep Cleanings" are therapeutic procedures, and are indicated for patients who require scaling and root planing due to bone loss and subsequent loss of attachment. Instrumentation of the exposed root surface to remove deposits is an integral part of this procedure. Local anesthetic is included for comfort and will not be an additional cost.
- D4921 is the dental code for the irrigation of gingival pockets with medicinal agent to disinfect after the deep cleaning. Your dentist may recommend full mouth debridement
- D4355 to enable a comprehensive oral periodontal evaluation and diagnosis on a subsequent visit.
- D4381 is used to indicate any crevicular agent used to treat periodontal disease, such as Arestin (localized antibiotic inserted directly into periodontal pocket to initiate healing).
15% Savings Includes:
Up to 15% savings on most other services/procedures for adults including, fillings, crowns, veneers, bridges, night guards, implants (implant radiographs and imaging, surgical guide, implant placement surgery, implant uncovering, and implant restorations, root canals, crown lengthening, laser treatments, frenectomies, gingivectomies, oral biopsies, dentures (full, partial, implant-supported overdentures), extractions, bone grafts.
Some exclusions apply, see Exclusions & Exceptions section
Orthodontic Savings Includes:
10% savings on Comprehensive Orthodontic Treatment including Clear Aligners and Braces.
Some exclusions apply, see Exclusions & Exceptions section.
EXCLUSIONS & EXCEPTIONS
Exclusions, Exceptions & Limitations
- Any procedures for full mouth rehabilitation.
- Child/Teen/Adult Comprehensive Orthodontic Treatment (Clear Aligners and Braces) will be 10% off
- Child Preceptive Treatment is excluded
- Orthodontic retainers are excluded
- Limited Orthodontic Cases are excluded
- All medications, fluoride toothpastes and nitrous oxide.
- A Child Plan is eligible for a patient with majority of their dentition as deciduous (baby) teeth. Once a child transitions to a majority adult dentition, the plan will be upgraded to an adult plan.
- All medical procedures such as Obstructive Sleep Apnea consultations and treatments or any other medical billing codes
- Any whitening services or products.
- All sports mouth guards.
- Your dentist may need to capture imaging (xrays) in addition to any “routine xrays” in order to properly diagnose treatment. These will not fall under the covered routine xrays and may be an additional charge. This is considered part of your “treatment” and a 15% courtesy will be applied.
- Hospitalization for any procedures for example child or adult seen for treatment under anesthesia in a Hospital Operating Room (OR).
- Adult fluoride and sealant treatments are excluded from 100% covered benefit and are allowed 15% savings
- Services unable to be completed due to the patients’ medical health, mental health or other unhealthy status.
- Conditions or services under Worker’s Compensation or Employer’s Liability laws.
- Congenital malformations other than congenital anomaly of tooth/teeth from birth.
- Any 3-dimensional radiographs including Cephalometric and Cone Beam Computed Tomography (also known as “CBCT” or “CT scan” or “CT Capture”)
- Any services provided for free by a county, government, municipality, or other agency.
- Any appliances, diagnosis or treatments conducted by a referral made to another dentist or specialist outside of the providers of our dental office in order to complete treatments in connection with any dental procedure in this dental office
- Certain treatment may not be right for you, although something may be an included benefit in your plan, it is up to the doctor to recommend care that is right for you. Periodontal Disease patients may not be eligible for orthodontic treatment based on health reasons, for example.
VIEW PROGRAM GUIDELINES
Program Guidelines
- Patient portion of bill is due at time of scheduling.
- Program cannot be used in conjunction with another dental plan or dental insurance.
- No refunds of premiums will be issued if participant decides not to utilize dental plan
- No membership card will be given. Your plan's effective date will be on file in our office.
- Program cannot be used at any office other than this office and its providers.
- Program cannot be used for referral to specialists or for hospital care. Plan cannot be used for costs of dental care which is covered under automobile medical.
- Program cannot be used for injuries covered under workers' compensation claim.
- Program cannot be used for treatment for which, in the sole opinion of our doctors, lies outside the realm of their capability.
- Membership is not transferrable.
Additional Information
- If you are a "Periodontal Plan Member" and are recommended to schedule additional cleanings during the year (more than 3/year), any additional preventive appointments will be offered at a 15% discount when payment in full is received at the time of services scheduled and will not fall under the 100% covered benefit.
- To use your Member Exclusive discount for restorative, elective or cosmetic treatment, Simply schedule an appointment with our office and be sure to tell us you’re a member. When you arrive, we’ll make sure your membership is "current" and you will be eligible for instant savings off our regular fees. Your membership activates immediately and is ready for use!
- All treatment paid for with third party financing (e.g. Care Credit, Cherry, etc) will be subject to a reduced discount of 5% - not 15% due to fees incurred into our office from third party financing.
- A missed appointment fee of $25 per 30 minutes of your scheduled treatment time will be charged for all missed dental appointments. Please notify our dental office at least 2 business days in advance if you must change your reserved appointment.
- After 3 missed appointments in accordance to our office policy, you will be asked to find a different dental provider and a dismissal letter will be issued.
- If a patient is dismissed from the practice, there will be no refund of Membership plan and the Membership plan will no longer be valid for use.
- There are no refunds on membership fees when any treatment provided equals or exceeds the costs of the membership fee.
- A lapse in coverage may be subject to a $75 reinstatement fee
- To check on the status of your account simply Login to your Account through our website and look under Membership Subscriptions. You'll see the status of each member above his/her name.
- To change or update my billing information Simply login to your Account and click "Update Your Payment Method".
THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act. This is not a Medicare prescription drug plan. The range of discounts will vary depending on the type of provider and service. The plan does not pay providers directly. Plan members must pay for all services but will receive a discount from participating providers. This plan is accepted at the dental practice where you purchased the plan. If unused, you may cancel within the first 14 days after receipt of membership materials or the effective date, whichever is later, and receive a full refund, less a nominal processing fee (nominal fee for MD residents is $5, AR and TN residents will be refunded processing fee). This plan is not available in Vermont or Washington, Utah.
Note: This plan's benefits are automatically terminated upon your activation of a dental insurance plan. As a parting gesture we will give you a coupon for one free dental cleaning good for twelve months.
TERMS & CONDITIONS
Renewal Conditions: By joining, you are authorizing the Plan to bill your credit card or checking account. This charge shall renew until you notify the Plan in writing of its cancellation. By joining you indicate you have read the terms and conditions of the Plan. This plan will automatically renew at the end of you membership term, and your credit card or bank account will be automatically charged or drafted for the appropriate amount.
Termination Conditions: MERCHANT and the Plan reserve the right to terminate plan members from its plan for any reason, including non-payment. If the Plan terminates the program or your membership for a reason other than non-payment, you will receive a pro-rata refund of your membership fees.
Cancellation Conditions: You have the right to cancel within 30 days from effective date and receive a full refund, less the processing fee, if applicable. If for any reason during this time period you are dissatisfied with the Plan and wish to cancel and obtain a refund, you must submit a written cancellation request. The Plan will accept cancellation requests at any time and will stop collecting membership fees in a reasonable amount of time, but no later than 30 days after receiving a cancellation notice. Please send a cancellation letter and a request for refund with your name and member ID to our MERCHANT Address or fax. You may also submit cancellation requests by email. When you cancel, you will continue to have access to the plan for the remainder of the period for which you have paid; your membership will terminate at the end of that period. The preceding sentence does not apply to quarterly, semi-annual or annual memberships in FL, ND and OK, where you will receive a pro-rata refund whenever you cancel.
Description of Services: Please see the product detail page for a specific description of the plan that you have purchased.
Limitations, Exclusions & Exceptions: This plan is offered by MERCHANT. The Plan is not a licensed insurer, health maintenance organization or other underwriter of health care services. No portion of any provider’s fees will be reimbursed or otherwise paid by the Plan. The Plan is not licensed to provide and does not provide medical services or items to individuals. You will receive discounts for services at certain health care providers who have contracted with the plan. You are obligated to pay for all health care services at the time of service. Savings are based upon the provider’s normal fees. Actual savings will vary depending upon location and specific services or products purchased. Please verify such services with each individual provider. The plan’s discounts may not be used in conjunction with any other discount plan or program. All listed or quoted prices are current prices by participating providers and subject to change without notice. Any procedures performed by a non-participating provider are not discounted. From time to time, certain providers may offer products or services to the general public at prices lower than the discounted prices available through this plan. In such event, members will be charged the lowest price. Discounts on professional services are not available where prohibited by law. This plan does not discount all procedures. Providers are subject to change without notice and services may vary in some states. It is the member’s responsibility to verify that the provider participates in the plan. At any time the Plan may substitute a provider network at its sole discretion. The Plan cannot guarantee the continued participation of any provider. If the provider leaves the plan, you will need to select another provider. Providers contracted by the Plan are solely responsible for the professional advice and treatment rendered to members and the Plan disclaims any liability with respect to such matters.
Complaint Procedure: If you would like to file a complaint regarding your plan membership, you must submit your complaint in writing to MERCHANT Address. You have the right to request an appeal if you are dissatisfied with the complaint resolution. After completing the complaint resolution process, if you remain dissatisfied you may contact your state consumer department.
