We are committed to providing you with the best possible dental care. If you have dental insurance,
we are anxious to help you receive your maximum allowable benefits. In order to achieve these goals, we need your assistance
and understanding of our payment policy.
If you will not be filing insurance, or if we do not work with your insurance provider, payment for office
services is due at the time services are rendered. We accept cash, checks and most major credit cards. We also work with Care
Credit and CitiCard if that option is needed.
Returned checks are subject to applicable bank fees of not less than $25.00.
We will gladly discuss your proposed treatment and answer any questions
related to your insurance.
realize, however, that:
If you have an indemnity plan, your insurance
is a contract between you, your employer and the insurance company.
Our fees are generally considered to fall
within the acceptable range by most insurance companies and, therefore, are covered up to the maximum allowance determined
by each carrier. Thus, our fees are considered to be usual and customary by most companies.
Not all services are covered benefits in all
contracts. Some insurance companies arbitrarily select certain services they will not cover.
FULL PAYMENT AND
ALL CO-PAYMENTS ARE TO BE MADE AT THE TIME OF SERVICE.
You are responsible for informing us of any
changes in your insurance plan or policy. Failure to do so may result in denial of coverage, the fees for which you will be
6. Deductibles, co-insurance and co-pays are the RESPONSIBILITY of the patient/policyholder.
We will do our best to estimate your portion
of treatment payments (but it is still an estimate), based on what your insurance companies past payments
have been. However, any portion not paid by insurance becomes your responsibility.
8. If your plan offers “Out-of-Network” benefits, you may be
seen as an “Out-of-Network” patient at a somewhat higher cost to you.
We must emphasize that, as dental care providers, we are dedicated to providing the best treatment to our patients.
We will do our best in the filing of insurance claims; however, if we have not received payment from the insurance company
after 60 days, you are responsible for the balance of your account. We will assist you in whatever way we can in handling
that balance, but ultimately it is up to you.
Thank you for understanding our Office Financial Policy. If you have any questions, please do not hesitate to ask.