Financial/Cancellation Policy

Thank you for choosing us as your dental health care provider. We believe that all patients deserve the very best dental care we can provide. As a condition of treatment by this office, financial arrangements must be made in advance. The practice depends upon reimbursement from patients for the costs incurred in their care.  Emergency dental services, or any dental services performed without previous financial arrangements, must be paid for in cash at the time services are performed unless other arrangements are made.  Third Party financing is available in our office through Wells Fargo Health Advantage
 
INSURANCE – We require that any co-payments, deductibles, and the fees for any services not covered by your insurance plan be paid at the time the service.  If there is any balance after your insurance pays their portion, or if your insurance company does not respond with payment in a timely fashion, (within 45 days), then the patient/parent is responsible for all balances. Please make sure to share complete insurance information and any other information necessary to process claims at your visit.  Failure to provide the necessary information to process your claim through our electronic submission platform may result in our inability to submit your claim.  WE SUBMIT ONLY ELECTRONIC CLAIMS, NO PAPER!   If we are not able to submit claims in our approved format for any of the reasons addressed above, then payment will immediately become due.
 
FINANCIAL ARRANGEMENTS – Payment is expected at the time of service.  We will do our best to estimate the portion that you will be responsible for and that for which your insurance will pay, but it is our best estimate only and is not a guarantee.  We will bill you promptly for any balances that you owe after your insurance has paid their portion and there will be no interest charged on the initial statement sent to notify you of your remaining balance due.  For any accounts with a balance due who have received more than one statement,  there is a fee of 1.5% monthly (18% annually) or a minimum $5 billing charge, whichever is the highest of the two, incurred for each month that a statement must be sent after the initial. There is a $30 fee for Returned Checks.  Any accounts 60 days or more past due will be turned over for collection.
 
SHORT NOTICE RESCHEDULE, CANCEL OR NO SHOW APPOINTMENT – We require at least 24 hours advance-notice for rescheduling or cancelling appointments.  Failure to provide notification may result in a ($65) charge for the missed appointment.