In our continued commitment to provide the highest quality dental care available to all of our patients, and to have those services affordable, we are pleased to offer you the following payment options: Visa, MasterCard, American Express, Discover, and Carecredit, cash, and check.

Patients are responsible for all charges resulting in dental care at our office. As a courtesy to you we will process your insurance claim. Should your insurance company delay payment you may be asked to participate in expediting payment. Please be aware that there are many insurance companies, and different programs within those companies. Our staff will do our best, but cannot be expected to be “experts” on what is covered or not covered by your insurance. The expectation of understanding falls to you.

By signing below, you understand and agree to be fully responsible for the total payment of all procedures performed. This includes any treatment that may not be a covered benefit with your insurance. You understand that any estimated portion not covered by insurance is due at the time of service, and that interest may occur on any portion of the unpaid balance.

PAYMENT PLANS: If we extend in office credit to you it is as a courtesy. We expect you to pay the agreed upon amount each month. If you fall behind with the agreed upon payments we will expect each visit be paid in full at the time of the appointment going forward.

NO SHOW/CANCELLATION: We respectfully request a 2-business day notice for cancellations or when rescheduling an appointment. This allows enough time to contact other patients waiting for treatment. If you are unable to allow the required notice you will be billed $75 per hygiene hour, and $150 per doctor hour.

If at any time you have questions or concerns please feel free to contact us. We are here to assist you in any way possible, and want to ensure you have an outstanding experience.