Office Policy
Thank you for choosing us as your dental care provider. Our office is committed to providing you with the best possible care. Please understand that payment of your bill is considered as part of your treatment. The following is a statement of our financial policy which we require you to read and sign prior to any treatment. All patients must complete our Information and Insurance form before seeing the doctor.
Payment Policy:
For non-insured patients, payment for services are due at the time of your office visit unless prior arrangements have been made with the Patient Coordinators. Payment options include cash, check, Mastercard, Visa, Discover, and Care Credit.
Checks that are returned to our office from your financial institution are subject to a $30.00 returned check fee. This fee covers the processing fees that are charged to our office.
As a courtesy to our patients, we file all claims to their insurance company. The patient is expected to pay all charges not covered by their insurance at the date of service, such as deductibles and/or copays.
If the insurance does not pay a claim, the patient will be responsible for charges and will be billed. You will have 30 days to take care of the balance.
The benefits quoted by your insurance company are just an estimate and are NOT A
GUARANTEE OF COVERAGE. You will be responsible for any amount not covered.
(Please be aware that some insurance companies downgrade the price of composite fillings to the amalgam price.)
For non-insured patients, payment for services are due at the time of your office visit unless prior arrangements have been made with the Patient Coordinators. Payment options include cash, check, Mastercard, Visa, Discover, and Care Credit.
Checks that are returned to our office from your financial institution are subject to a $30.00 returned check fee. This fee covers the processing fees that are charged to our office.
As a courtesy to our patients, we file all claims to their insurance company. The patient is expected to pay all charges not covered by their insurance at the date of service, such as deductibles and/or copays.
If the insurance does not pay a claim, the patient will be responsible for charges and will be billed. You will have 30 days to take care of the balance.
The benefits quoted by your insurance company are just an estimate and are NOT A
GUARANTEE OF COVERAGE. You will be responsible for any amount not covered.
(Please be aware that some insurance companies downgrade the price of composite fillings to the amalgam price.)
Missed Appointment Policy:
When you are scheduled for an appointment, the time is reserved just for you. If an appointment cannot be kept, kindly give 48 business hours notice so that another patient may have your appointment time. There will be a broken appointment fee charged for missed appointments and if we are not notified in a timely manner of your need to cancel an appointment. If you are more than 15 minutes late to your appointment, we consider this a missed appointment and a fee may be charged.
When you are scheduled for an appointment, the time is reserved just for you. If an appointment cannot be kept, kindly give 48 business hours notice so that another patient may have your appointment time. There will be a broken appointment fee charged for missed appointments and if we are not notified in a timely manner of your need to cancel an appointment. If you are more than 15 minutes late to your appointment, we consider this a missed appointment and a fee may be charged.