Financial Policy
Thank you for choosing us as your dental care provider. We believe that all patients deserve a beautiful, healthy smile with the best care and education available.
Everyone benefits when clear financial arrangements are agreed upon. 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 that you read and sign prior to any treatment. All Patients MUST complete all patient and financial forms before seeing the doctor.
Payment:
FULL payment is due by the time of service, unless other financial arrangements have been agreed upon and signed for in advance.
Payment methods we accept:
1.) Cash
2.) Checks
3.) Credit/Debit cards
4.) Care Credit
5.) Proceed Financing
We offer a complete Financial Menu to allow you to choose financial arrangements that best fit your needs. If you need help navigating these options, our team is more than happy to assist you.
Insurance:
We cannot guarantee your insurance benefits or coverage:
In order for us to submit claims on your behalf, you must provide all of your insurance information to us prior to your appointment.
As a courtesy service, we will facilitate the claims process for you and do our best to provide accurate information; however, benefit determinations are decided solely by your insurance company. Therefore, any insurance information we provide is an ESTIMATE only.
You are responsible for any limitations or restrictions on your individual insurance plan, such as deductibles, copays, maximums, allowed amounts, coverage percentages, non-covered services, etc. Due to variability in individual plans and coverages, we advise you to maintain a copy of your specific insurance plan benefits for your own reference.
For patients with Out of Network plans, the full balance of your treatment is due by the time of your treatment appointment.
For patients with In-Network plans, the estimated patient portion of your
treatment is due by the time of your treatment appointment. This includes all copayments, deductibles, and any amount either not covered by your plan or over your plan’s annual maximum.
Any remaining balance following insurance processing is the patient’s
responsibility, whether the insurance company pays or not.
Treatment Plan Estimates:
We provide Treatment Plan estimates for your convenience, which includes a 90
day guarantee of our office fees and any non-insurance related discounts listed on
the Treatment Plan. However, any insurance information provided on the
Treatment Plan, including insurance discounts, is a courtesy estimate only and not guaranteed.
Not all services are “covered” by insurance:
Our doctors base treatment recommendations on what we believe is best for your health, regardless of your level of insurance coverage.
Unfortunately, many dental insurance plans only cover a minimal portion of what they consider as “preventative” treatment with very limited, restrictive, or no benefits towards your needed dental care.
Please be aware that your dental insurance plan may not cover all recommended treatment, and that this does not mean you should forgo treatment.
Usual and Customary Rates
Our practice is committed to providing the best treatment for our patients, and our fees are usual and customary for both our area and our doctors’ level of expertise and training. Patients are responsible for payment regardless of any insurance company’s determination of rates. Patients are responsible for full payment at the time of service, unless they are in network with the PPO’s we have chosen to work with. Remember that not all procedures are covered.
Minor Patients
The parent/guardian or adult accompanying a minor patient is responsible for full payment at the time of service. For unaccompanied minors, Non emergency treatment will be denied unless charges have been pre-authorized to an approved payment method.
Missed Appointments
No-shows or late cancellations are subject to a Missed Appointment fee of
$79 per Hour scheduled
Three no-show or cancellations in a calendar year will result in same-day only scheduling.
Excessive cancellations and no shows will result in dismissal from the practice.
Refunds
Refunds for any overpayment will be sent to the patient after all treatment is completed, insurance has been collected, and account balances have been satisfied.
Collections
Any account that has not received payment within 60 days will be handed over to a third party collections agency.
Thank you for reviewing and understanding our financial policy. We are here to serve you and to help you achieve your oral health goals. Should you have any questions or concerns, please contact us.