Welcome to Miller Dental Arts:
The following statement of our office policy is intended for your information. We want to keep our patients aware of all our office procedures.
Appointments: Please give us at least 48 hours notice if you must cancel an appointment. This way we can offer the time to another patient. If you cancel an appointment with less than 24 hours notice, or fail to appear for your scheduled time, there will be a $50 charge. Please remember that the purpose of a "missed appointment" fee is to encourage a sense of responsibility for our time, and is not intended to recover most or all of the fees for the planned but "missed" procedure. Conversely, we have the respect for your time and we try to see all of our patients on schedule.
Sterilization: be assured that our primary concern is for your health and safety. All of our instruments and handpieces are heat sterilized. We are in compliance with all OSHA and New Jersey state regulations.
Fees and Insurances: Our office provides quality personalized care. The doctor/patient relationship is precious. No third-party should interfere with this relationship. An insurance company should not dictate treatment. Regardless of your coverage, we will suggest the best care that is appropriate for you. You will be involved in the treatment planning process.
Ultimately, you are financially responsible for the cost of this care, even if we participate in your insurance plan. Any services that are not covered by your insurance are your responsibility. If we do not participate with your insurance plan, he will pay Miller Dental Arts and your insurance company will reimburse you to the extent of your coverage. All insurance plans are different, it is the patients responsibility to know and understand his/her own plan.
If your insurance benefits have been predetermined prior to treatment, we will wait 60 days for the insurance payments to come directly to us. the patient must pay all co-payments at the time of treatment.
After 60 days from the time of service, all balances must be paid in full if your insurance company has not done so. Your insurance company is a third-party payer and responsible only to the insured. Therefore, you must take an active role in seeing that your insurance company pays Miller Dental Arts before the 60 day elapsed. Should this result in an overpayment, the doctor will refund it to you.
Major treatment: all crown and bridge work requires a minimum down payment of 50% at the first treatment appointment. The balance must be completely paid when the case is complete.
Payment plan: we offer a payment plan for dental treatment involving several office visits as follows:
A minimum payment of 50% is due at the first visit. The balance, which includes payment charges of 18% per year on an unpaid balance, will be paid when the case is complete.
Method of Payment: all payments can be made by Cash, ApplePay, Visa, MasterCard, or AMEX. Personal Checks are accepted on a case-by-case basis, and a $50 charge will be imposed for returned checks. We also participate with Care Credit. Arrangements for financing a course of treatment can be made through them.
Please read and sign the agreement below. If you have any questions, we will be happy to answer them.
I hereby authorize and guarantee payments for all services rendered. I agreed to pay any amount my insurance company does not or will not pay. I agree to pay a late charge of 18% per year on any balance 30 days past due as well as collection cost, court costs, attorney fees and interest fees accrued with the collection of this account. I have been given a copy of this agreement.