DENTAL INSURANCE COVERAGE NOTICE AND DISCLAIMER
Lakeside Dental Arts and their associates are committed to helping patients with their dental insurance.
- My dental insurance coverage is a contract between the insurance company and myself.
- My coverage is determined by my choice of dental insurance plan. Lakeside Dental Arts and their associates have no involvement with the insurance company fee allowances or payments.
- My dental insurance is not Lakeside Dental Arts’s responsibility. The practice will file my insurance as a courtesy to me. Lakeside Dental Arts is not responsible for delays in payment or determinations of coverage.
- I understand my dental insurance company may not communicate with Lakeside Dental Arts. I may need to contact Lakeside Dental Arts to inform them of any dental insurance issues.
- Lakeside Dental Arts and their associates cannot make ANY representation of warranty that my dental insurance company will cover all or any portion of the dental services provided.
- I understand it is my sole responsibility for payment of services regardless of my dental insurance coverage.
After reading this Notice and Disclaimer concerning my dental insurance coverage, I understand and agree to the terms and conditions above.