Payment is due at the time of services are rendered. For your convenience, we accept cash, Visa, MasterCard, Discover, American Express, personal checks, money orders, or registered checks.
Insurance benefits are determined by your employer and not your dentist. We will do our best to determine what insurance benefits are available to you however, companies are making changes to their benefits packages constantly. As a result of this, we cannot guarantee any quoted estimate and you are responsible for all costs of treatment not paid by your insurance. As a courtesy, we will be glad to file your insurance claim for you and accept assignment of your available insurance benefits any deductible or estimated co-payment amount will be due at the time of treatment. You will be expected to pay for services rendered if the office is unable to verify your insurance information before treatment.
In our office appointments are reserved exclusively for you so we reserve the right to charge and collect fees for broken appointments-appointments that are canceled or broken without 48-hours advance notice. As a health benefit to you, we may offer to move your appointment to an earlier time if openings arise.
Returned Check Fee: $40.00 will be added to your account balance and is collectible.
Payment plans and financial arrangements can be entered into for comprehensive dental treatment, prior to commencing treatment.
I have read and understand this financial policy.
