Financial Information

1. Dental Service:
Payment is required at time of service. Forms of payment accepted are cash, check, MasterCard, Visa, Discover and CareCredit. CareCredit allows you convenient options to break your payment into monthly payments. Please visit CareCredit to apply for their convenient payment plan. If a check is returned for any reason there is $25.00 charge for bank fees incurred.

2. Insurance Billing:
The patient and/or guarantor is responsible for verification of insurance benefits. We will contact your insurance company to verify benefits and eligibility. However, we are unable to guarantee payment from your insurance company. Dental Insurance is designed to cover some, but not all of your dental treatment. We will do everything we can to maximize your dental insurance benefits, but it is best to understand that you are ultimately responsible for the total balance on your account. Any outstanding balance that is not covered by insurance is your responsibility. Finance charges are incurred on any account over 90 days (see past due accounts note below). We do not pre-authorize dental or medical treatment unless requested by the patient. Predeterminations are still not a guarantee of payment and can take insurance companies up to 30-45 days to process.

If it is necessary to obtain a CBCT scan we will bill your insurance. Most insurance companies do not cover this service and charges will be your responsibility.

*WE ARE NOT A PREFERRED PROVIDER WITH ANY INSURANCE.
*WE ARE NOT MEDICARE/MEDICAID PROVIDERS AND CANNOT SUBMIT CLAIMS TO THEM.
*WE DO NOT ACCEPT WORKER’S COMPENSATION OR MOTOR VEHICLE ACCIDENT CLAIMS.

3. Late Appointments/Cancellations/No-Shows:
Patients arriving late to their scheduled appointment time may be rescheduled in order to meet the needs of those patients who are on time for their pre-reserved visit. We request a minimum of 48 hours notice to cancel or re-schedule an appointment. If an appointment is cancelled with less than a 48 hour notice and we are unable to fill your spot, or you do not show up for your scheduled appointment, you will be responsible for 35% of the fees for the treatment scheduled.

4. Past Due Accounts:
Any account that is delinquent and turned over to a collection agency will have a collection fee applied of $75 or 35% (whichever is greater) and will be responsible for any attorney fees. Any collection account seeking further services with our office will be required to pay in full day of service (including outstanding balances). All accounts over 90 days past due will be charged a service charge of 1.5%. A minimum service charge of $1.00 per month will be charged.