Financial Policy

  • Financial Policy

    In an effort to keep dental costs down while maintaining a high level of professional care, we have established the following financial policy for our patients. Our primary responsibility is to help our patients experience good health and we wish to spend our time and energy toward that end. Therefore, we would like to take the time now to fully explain our policy to you in order to avoid any misunderstanding in the future.

    We accept cash, checks, debit cards, CareCredit, American Express, Visa, Discover, and Mastercard. Your treatment needs to be paid for at the time of service. If you need to make payments, you can apply for CareCredit in this office.

    We accept dental insurance and, as a service to our patients, will be happy to bill the insurance carrier for you. We have found that insurance rarely pays 100% of the fee for service, therefore we ask that all estimated copayments, based on the percentage your insurance should pay, be paid for at the time of service. After the insurance had paid, you will be sent a final statement showing any remaining balance due to this office. That final payment is due upon receipt of statement. Please remember that whatever your insurance arrangements are, you are responsible for the payment of your dental care.

    Balances exceeding 60 days will be charged a service fee of 18% per annum. Returned checks will be charged a fee of $25.00.

    An appointment is a reservation of our office and staff for your treatment needs. This time is deprived from someone else if we do not have adequate notice for cancellations. Please give us a minimum of 24 hours’ notice from our last business day if you cannot keep your appointment. A fee of $100.00 will be charged if you miss your appointment without adequate notice. In some instances, insurance payments may be more than our office estimated for coverage. In this case any credit of $15.00 or less will remain on your account for future treatment unless you request otherwise. Any credits for $15.01 or greater our office will call to notify you of and issue a refund check or leave on account at your request.

    I have read this financial policy and understand that, regardless of any insurance coverage I may have, I am fully responsible for payment of my account within the limits of this credit policy. I agree that in the event costs and/or fees are incurred in connection with the collection of my account, I will pay all such costs and fees, including billing costs, collection costs, attorney’s fees, and any court costs.

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