Thank you for choosing our office as your dental health care provider. We are committed to providing you with the highest quality dental care so that you may fully attain optimum oral health. This statement is to inform you of our financial policy and our intent to facilitate excellent service specific to your treatment while minimizing administrative costs.
All charges you incur are your responsibility regardless of your insurance coverage. We must emphasize that as a dental provider, our relationship is with our patient not the insurance company. As a courtesy to all of our insured patients, we will file your dental insurance claim forms. We ask that you pay the deductible and co-payment, which is your estimated patient portion or amount not covered by your insurance carrier, at the time of service. We emphasize this is only an estimate and all charges you incur are your responsibility. We accept Check, Cash, Visa, Mastercard, Amex. Also, we accept CareCredit and offer no interest payment plans up to 6 months. We do not accept payment plans.
Insurance companies have a wide variety of rules, plan limitations, and exclusions that our office may not be aware of. Not all services are covered benefits in all contracts. It is your responsibility to thoroughly understand the coverage and expectations of your particular policy. Your claim will be filed immediately and insurance benefits are anticipated to be issued within 30-45 days. If the claim is not cleared in 60 days, the unpaid portion will automatically become “self-pay”. You are responsible for amounts not paid by your insurance company.
Minor Patients: The parent or guardian accompanying the minor is responsible for full payment. In the case of divorced or separated parents, the parent accompanying the child is responsible for payment without any exception. This office will not attempt to collect payment from a parent that is not present in the office at that visit.
Patients 18 and over: The Fair Debt Collection Practices Act (FDCPA) and the Health Insurance Portability and Accountability Act (HIPAA) require any patient 18 and over to be financially responsible for payment without any exception. This will be the case even if the patient is financially reliant on a parent or guardian, or are covered under parents’ insurance. Also, any overpayment made on an account will be refunded under the patient’s name.
Delinquent balances over 90 days will be referred over to a Collection Agency and a 30% fee will be added to your account. Your account will become “Inactive” and will remain “Inactive” until paid in full, including collection fee.