FINANCIAL/INSURANCE:

PATIENTS WITH DELTA PREMIER. We are a Delta Premier Provider and because of this you will get a discount from our base office fees. We will estimate the part of your bill that Delta will not cover and those amounts will be due at the time of service. This is an estimate only. If there is a balance after Delta pays, it will be due within 30 days of the date on your first statement.

For all other insurances: we are an out-of-network provider and PAYMENT IN FULL is expected at the time of service unless previous arrangements are made. As a courtesy to you, we will help you process all of your dental insurance claims and your insurance company will reimburse you at the level of coverage of your policy. Please understand that we will provide an insurance estimate to you; however, it is not a guarantee that your insurance will pay exactly as estimated. Insurance coverage is subject to limitations, exclusions, waiting periods, frequency, age restrictions, deductibles and maximums which are your responsibility. Please contact your insurance company for a detail of your benefits. Your insurance company and your plan benefits ultimately determine the amount paid. We will do all we can to ensure your estimate is as accurate as possible. Your estimated insurance benefit may differ due to a number of reasons, specifically related to your plan.

All charges you incur are your responsibility, regardless of your insurance coverage. We must emphasize that as your dental care provider, our relationship is with you, our patient, not with your insurance company. Your insurance policy is a contract between you and your insurance company. Our office is not a party to that contract.

Our practice is committed to providing the best treatment for our patients and we charge what is usual and customary for our area. You are responsible for payment regardless of any insurance company’s arbitrary determination of usual and customary rates.

Insurance payments are ordinarily received within 30-60 days from the time of f iling a claim. If your insurance company has not made payment within 60 days, you should contact your insurance company to make sure payment is expected. If payment is not received or your claim is denied, we will help you as much as we are able to get the claim paid.

We will cooperate fully with the regulations and requests of your insurance company that may assist in the claim being paid. Our office will not, however, enter into a dispute with your insurance company over any claim.

Minors accompanied by the parent or legal guardian:

The parent or legal guardian accompanying a minor, who has consented to treatment, is responsible for full payment at time of service.

Please Note: Payment is due at the time service is provided. Our office accepts cash, personal checks, MasterCard, Visa, Discover, American Express and CareCredit. Internal financing is available upon request and approval. 

Unaccompanied Minors: Parents must fill out an Unaccompanied Minor Consent form. The parent or legal guardian is responsible for full payment at time of service. Treatment consents and payment arrangements with the parent or legal guardian must be made prior to appointment or non-emergency treatment may be denied.

Missed Appointment(s) and Cancellations:

Our goal is to provide treatment in a timely manner with as few visits as necessary. In order to provide the best services to our patients, we require at least a 48 hour notice for cancellations or for rescheduling your appointments. We understand that unforeseen circumstances may arise, which may result in canceling or missing your appointment. If late cancellations or no-shows are excessive (over 3 per family), we reserve the right to dismiss all family members from practice.