Thank you for choosing us as your dental 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. Our financial policy is intended to facilitate excellent service to you while minimizing administrative costs. The following is a statement of our Financial Policy which we require you to read and sign prior to any treatment.
We accept the following forms of payment: Cash, Check, Visa, MasterCard, Discover,
AmericanExpress, and Care Credit (a third party financial group offering a line of credit
for dental/medical fees for those who qualify). Payment for services is due at the time services are rendered.
If dentures, partial dentures, crown and bridge are to be fabricated by a dental laboratory, a 50% deposit will be required at the time of the first impression. The remaining balance is due at the time the prosthesis is cemented or inserted.
The parent that accompanies the minor child/children to the appointment is responsible for any payment due. For unaccompanied minors, non-emergency treatment will be denied unless prior arrangements have been made with the practice manager.
Once an appointment has been made, that time is reserved specifically for you. We reserve the right to charge a fee for cancelled or missed appointments without 48-hours notice.
There will be a $25.00 fee for returned checks.
In the rare event that your account becomes past due and is referred to an outside agency or attorney, you will be responsible for all collection costs, reasonable attorney fees, and court fees incurred by this office.
Your insurance policy is a contract between you and your insurance provider. Because
insurance policies vary greatly, we can estimate your coverage in good faith, but cannot
guarantee it. As a service to our patients, we will be happy to submit your dental claim on
your behalf. Ultimately you are responsible for all fees generated by your treatment.
All insurance co-pays and deductibles must be paid at the time of service.