Office Policies

Thank you for choosing us as your dental health care provider. We are committed to dental excellence, superior quality, and outstanding customer service. Payment of your bill is considered part of your treatment. The following is a statement of our financial agreement, which outlines our office policies. Please read and sign this form prior to beginning any treatment.

Full payment is due at time of service. We accept cash, checks, Visa, Mastercard, American Express, or Discover. We also offer extended payment plans with prior credit approval.

Regarding Insurance:

All co-payments and deductibles are due on the date of service. 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 bill is your responsibility whether your insurance company pays or not. We cannot bill your insurance company unless you give us all of your insurance information. All major services have to be pre-approved for benefits by your insurance carrier.

Usual and Customary Rates:

Our practice is committed to providing the best treatment for our patients and our fees are based on a variety of factors specific to our practice and our area. The insurance program you or your employer has chosen may base its dollar allowance on a fee schedule, which may not coincide with our practice’s current fees, and you will be responsible for the remaining balance. The insurance company often has its own arbitrary way of determining what is usual and customary.

Minor Patients and Students:

The adult(s) accompanying a minor and/or the parents or guardians are the individuals responsible for full payment. For unaccompanied minors or students, non-emergency treatment will be denied unless charges have been pre-authorized to an approved credit plan, credit card, or payment by cash or check at the time services are rendered.

Missed Appointments:

Unless cancelled at least 24 hrs in advance, our policy is to charge for missed appointments. Please help us serve all our patients better by keeping scheduled appointments.

Thank you for understanding our financial agreement. Please let us know if you have any questions or concerns.