Financial Guidelines

Our primary responsibility is to help our patients experience good dental health and we wish to spend our time and energy toward that end.

To avoid misunderstandings, we would like you to know about our financial guidelines and office routines.

WHAT YOU MAY EXPECT FROM US:

We will diagnose dental problems as accurately as possible; but be aware that changes may become necessary after treatment is started.

Based on our diagnosis, we will estimate the total cost prior to performing treatment.

If you have insurance, we will break down the expected insurance benefit and your co-payment.

As a courtesy, we will usually bill your insurance for you after treatment is completed.

After insurance pays, we will notify you of any difference between the actual and estimated insurance payment.

We will promptly credit you any overpayment or ask you to promptly pay for any underpayment.

WE OFFER THE FOLLOWING FINANCIAL OPTIONS TO MAKE TREATMENT AFFORDABLE:

Asking the doctor to review the treatment alternatives again.

Spreading treatment appointments to fit your financial schedule.

Prepaying through a “lay-away” type payment plan.

Post-dating checks, on approved credit.

Using automatic debit/credit card billing.

Receiving a 10% non-billing discount (7% if by credit card).

Financing for up to five years through a third party Credit Line.

WHAT WE EXPECT FROM THE PARENT OR LEGAL GUARDIAN:

If we do not have to bill you or your insurance, a 10% non-billing discount is applied (7% if paid by credit card) when the entire estimated payment is made.

If you would like us to bill your insurance, we need accurate personal and insurance information. You may be asked to provide a copy of your driver’s license and insurance card.

Payment of your estimated co-payment is requested at the time of service if insurance is being billed.

Payment in full if a balance is due when you receive the billing statement.

Accounts unpaid for over 60 days may accrue interest at 18% per year, or 1.5% per month.

We must use the doctor’s time efficiently and help children who need our care. We request 48 hours notice to cancel or reschedule an appointment. A fee of up to $50 may be charged for appointments missed or cancelled without 24 hours notice.

INFORMATION ABOUT DENTAL INSURANCE

You (not your insurance carrier) are ultimately responsible for payment. Please understand that your dental insurance benefit program is a contract between you, your employer, and your insurance carrier. We are not a party to that contract. Our fees do not necessarily fall within the “UCR” structure determined by your carrier and remember that not all services are covered by all carriers.

OFFICE ROUTINES YOU SHOULD REMEMBER:

We accept personal checks (once credit is established), cash, bank debit cards, Visa, and MasterCard. If your check is returned to us for Non Sufficient Funds, you will be charged a fee of $25.