Office Financial Policy

Thank you for choosing us as your dental care provider. We believe that every patient deserves the very best in dental care. We also believe that everyone benefits when specific financial agreements are agree upon in advance. The following is a statement of our Financial Policy, which we require that you read and sign prior to any treatment.
Regarding Insurance

We request that any co-payments, deductibles, and any services not covered by your insurance company to be paid on the date of service. The balance is your responsibility whether or not your insurance company pays us. We cannot bill your insurance unless you provide us with the information at your initial visit. In addition, please update us on any and all changes to your insurance, including type, group number, indentification number, etc. Most importantly, you must notify us if your employer changes.

Please be aware that your dental insurance policy is in an agreement between you and your insurance company. If your insurance has not paid us within 90 days, the entire balance will automatically be transferred to your account. Note that some, and possibly all of the services provided may be non-covered under the terms of your policy. YOU ARE ULTIMATELY RESPONSIBLE FOR ANY AND ALL CHARGES NOT PAID BY YOUR INSURANCE COMPANY FOR ANY REASON.

Usual and Customary Rates

Our practice is committed to providing the best treatment for our patients, and our fees fall within "reasonable and customary" for our area. The treatment plan made by our doctors is based upon the dental necessity of your child, NOT the type or amount of dental coverage you have. 

Collections

Any outstanding account for which we have no received payment in 90 days will be assessed a $25.00 collection fee, and be forwarded to a collection agency. In addition all returned checks will be subject to the returned check fee. 

Thank you for reviewing our financial policy. We look forward to providing the highest quality dental care.

We schedule our appointments so that each patient receives the right amount of time to be seen by our physicians and staff. That’s why it is very important that you keep your scheduled appointment with us, and arrive on time.

As a courtesy, and to help patients remember their scheduled appointments, our practice sends text message and email reminders in advance of the appointment time.
If your schedule changes and you cannot keep your appointment, please contact us so we may reschedule you, and accommodate those patients who are waiting for an appointment. As a courtesy to our office as well as to those patients who are waiting to schedule with the physician, please give us at least 24 hours notice.

If you do not cancel or reschedule your appointment with at least 24 hours notice, we may assess a $25 “no-show” service charge to your account. This “no-show charge” is not reimbursable by your insurance company. You will be billed directly for it.

After three consecutive no-shows to your appointment, our practice may decide to terminate its relationship with you.

**Please note that major procedures such as oral surgery, periodontics and endodontics (root canals) will require a $50 deposit, paid at the time the appointment is made. This deposit fee will be returned to you or can be credited towards your procedure if appointment is kept. Failure to show for the appointment without appropriate 48 hour notice will result in loss of deposit fee paid. Please understand that this is due to the long length of appointments needed for such procedures.