Thank you for choosing our dental practice for your care.
We are committed to your treatment and experience being successful and pleasant. Please understand that payment of your bill is considered a part of your treatment. The following is a statement of our Financial Policy which we require you to read and sign prior to any treatment. All balances are due upon services rendered.
Major Service Arrangements
(Periodontal Surgeries Etc.)
The dental office may require a deposit against the total charges in major procedures and any treatment requiring more than one (1) hour of time.
Insurance Company Verification & Rejected Claims.
Please remember your insurance policy is a contract between you and your insurance company. We are not contracted providers for any insurance plan. As a courtesy we will accept assignment of benefits in selected cases. All co-payments and deductibles are due prior to treatment in order to reserve the appointment time. We require a credit card with authorization to bill the account for any balance your insurance company has not paid within 45 days of treatment rendered. Other arrangements with our extended payment plan may be arranged (Care Credit) to do the same.
Please be aware that some, and perhaps all, of the services provided may be non-covered services and not considered reasonable and necessary under your insurance. All dental insurance coverage needs to be verified before any services are rendered. In the event of an emergency the patient is responsible for emergency treatment, and the insurance will reimburse the patient.
Pre-Treatment Estimates are sent for all basic and major services before treatment can begin. If patient decides to start treatment without estimates from his/her dental insurance, they will be responsible to pay the complete charges of the treatment rendered and we will have the insurance company reimbursed the patient directly from the insurance company.
NOTE: Verification of insurance is NOT a guarantee of coverage: If the insurance company pays less than estimated amount then the patient is responsible for the remaining balance. You are responsible for payment regardless of any insurance company's arbitrary determination of usual and customary rates.
If a claim for services is rejected by the insurance company due to plan exclusions, clauses, waiting periods, cancellation of coverage, or any other reasons, the balance will be the patient's responsibility. Please remember our practice charges what is usual and customary for our area.
Bad Debit /
If an account is not paid in full or satisfactory arrangements are not made within the allowable time, the dental office reserves the right to refer the account to an attorney and/or a collection agency for collection of the balance. In the event the account is sent to collection, their fees will be added to the delinquent balance.
This valuable time is reserved to provide you with quality dental care. We make every effort to honor all time commitments and request that you extend the same courtesy to us. Unless cancelled, at least 48 hours in advance, our policy is to charge for missed appointments at the rate of a normal office visit, which is $75.00 every hour missed.
Please help us serve you better by honoring scheduled appointments