OUR FINANCIAL POLICY

We are committed to providing you with the best possible care, and we are pleased to discuss our professional fees with you at any time. Your clear understanding of our Financial Policy is important to our professional relationship. Please ask if you have any questions about our fees, Financial Policy, or your responsibility.

• All patients must complete our “Patient Information Forms” before seeing the doctor.
• FULL PAYMENT IS DUE AT TIME OF SERVICE.
• We accept cash, checks, Visa, Mastercard and Care Credit.

ADULT PATIENTS

Adult patients are responsible for full payment at time of service.

MINOR ACCOMPANIED BY AN ADULT

The adult accompanying a minor, and his/her parents (or guardians), are responsible for full payment at time of service. If a parent/guardian cannot accompany minor, the Parent/Guardian Consent form must be signed for dental care to be provided.

UNACCOMPANIED MINORS
The parents (or guardians) are responsible for full payment. Non-emergency treatment will be denied unless charges have been pre-authorized to an approved credit plan or Visa/Mastercard, or paid by cash or check at time of service.

REGARDING DENTAL INSURANCE
We will accept insurance on your first visit if you obtain approval from our office staff prior to the date of service.

If we accept your insurance, you must pay the copayment at time of service. If your insurance company has not paid the FULL BALANCE within 45 days, you have 15 days to pay the balance. Late Payment Charges are added to unpaid accounts after 60 days from the date of service. If you have secondary insurance it is your responsibility to file claims with that carrier. We will give you instructions on how to file secondary claims. Periodontal treatment-gum therapy-is considered “basic” not preventive, therefore co-payments will be collected at time of service for these procedures.)

Insurance is a contract between you and your insurance company. We will not become involved in disputes between you and your insurance company regarding deductibles, co-payments, covered charges, secondary insurance, “usual & customary” charges, etc. other than to supply factual information as necessary. Your are responsible for the timely payment of your account.

MISSED APPOINTMENTS
Unless you have canceled at least 48 hours in advance, our policy is to charge for the missed appointments at the rate of a normal office visit. Please allow 2 working days notice to reschedule an appointment. Changes in appointments scheduled on Mondays require notification to our office by noon on the preceding Thursday. Please help us serve you better by keeping scheduled appointments.