We are pleased to welcome you to our practice. In order to keep dental costs down, we request that patients pay at the time services are rendered unless other arrangements have been made with the business office.
CareCredit is a credit card that is specifically designed for healthcare needs. It’s a convenient way to pay for the costs of treatment with monthly payments.
Please provide our office team with accurate dental insurance information and the proper mailing address of the insurance company, or provide a dental claim form from your employer. If you do not have these forms at the time of the appointment, you will be responsible for payment of all fees.
Our practice is committed to you by providing you with the best quality dental care available. Our fees are determined upon the usual and customary rates for our area, regardless of an insurance company’s arbitrary determination of usual and customary rates.
As a benefit to you, we submit all insurance claims and obtain the dental benefits you and your family are eligible to receive through your insurance carrier. However, this is only an estimate of coverage. Your insurance policy is a contract between you and your insurance company. We are not a party to that contract; therefore, the balance of your account is your responsibility regardless of what your insurance company reimburses for services rendered.
We require your deductible or estimated co-pay be paid at the time of service. We cannot bill an insurance company for any claim unless all information to file claims is received. We request a copy of an original insurance card annually. If your insurance company has not paid its portion in 60 days after services have been rendered, the amount outstanding to the insurance company will be transferred to your account and will be your sole responsibility.
If sufficient insurance information is not received, the entire fee for services is due at the time of the appointment.
Notice: Medicaid Plans
We are a participating provider with some Medicaid plans. Please call for details.
Cancelling or No Show Appointment
We understand that occasionally situations may arise to warrant cancelling an appointment. Unfortunately, cancelling an appointment leaves a serious void in our schedule. We request 48 hours advance notice of cancellations so other patients can be scheduled. We reserve the right to charge $60 for an appointment cancelled or broken without 48 hours advance notice.