Office Policies

Financial Agreement

Our office understands the value of insurance benefits, and we are happy to assist you in filling the necessary forms. This is done as a courtesy to our patients and there is no guarantee of coverage. The insurance carriers base the amount of benefits on a fee schedule that they arbitrarily develop. For this reason, you may receive less of a benefit than we estimate for you. Your insurance policy is an agreement between you and your insurance carrier; therefore, all patients are directly responsible for all charges. Our patient coordinators will make every effort to help you maximize your insurance benefits.

Once your insurance carrier has paid, you will be responsible for any difference upon receipt of our statement. If for any reason your insurance carrier has not paid within 60 days from the date of treatment, you are responsible for the entire balance at that time. In addition, the unpaid balance may be subject to an 18% annual percentage rate (APR) interest charge. In the event of default, legal interest on the indebtedness, collection costs (which could be as high as an additional 50%) and related attorney’s fee could also be added.

Cancellation Agreement

Our office requires 24-hour notice for any cancellation. This is so we can allocate other patients in need of urgent dental care. A $50.00 fee will be charged if less than 24 hours notice is given. This fee is entirely the patient’s responsibility, and is not covered by your insurance.

Payment Agreement

Payments are expected at the time services are rendered. Payment and charges made at the time of services are estimates until your insurance carriers and the provider have made the appropriate adjustments to your account. Insurance companies may deny your claim, at which time you are responsible for the entire balance.

We accept the following: MasterCard, Visa, American Express, Discover, Cash, Check, CareCredit, or Lending Club. We do not offer any in-house finance options.