Patient Info
Your initial appointment usually will consist of an examination and review of your treatment options. Usually, treatment can be done or started the same day as the consultation. However, a complex medical history or treatment plan will require an evaluation and a second appointment to provide treatment on another day.
Please assist us by providing the following information at the time of your consultation:
- Any x-rays taken by a previous dentist, if applicable.
- A list of medications you are presently taking.
- If you have dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.
IMPORTANT: All patients under the age of 18 must be accompanied by a parent or guardian.
Financing
Financial Policy
We are committed to providing you the best possible care. Our office is not contracted as a provider for any insurance company due to the limitations they attach to treatment, regardless of the diagnosis. Our commitment is to you, our patient, not to any insurance company.
Your insurance benefits have been negotiated and purchased by your employer and offered as a benefit to you. The contract is between you, your insurance company, and your employer. We are not a party to that contract and do not have any specific information regarding your benefits.
Please keep in mind we are an in-network provider with Delta Dental; however, we are not in network with any other insurances.
As a courtesy, we will assist you in filing electronic claims to receive the maximum “out of network” benefits you are eligible to receive. Because we have no guarantee of payment or a specific payment amount from your insurance company, we ask that all of our patients secure financial arrangements prior to their scheduled appointment.
We offer several options regarding financial arrangements for treatment:
- Payments may be made in full by Visa, MasterCard, or Discover.
- Payments made in full by cash or check will be adjusted less 5% as a courtesy.
- Extended payments can be arranged by using an outside lending source such as Care Credit, which offers payment plans for six to twelve months with no interest. If outside financing is used, the entire fee, less a usage fee of up to 5%, will be applied and your insurance reimbursement will be mailed directly to you.
- For restorative work, we require a 60% down payment. We will file your insurance and wait for the “assignment of benefits” from your insurance company for up to 30 days. We require a signed “Signature on File” authorization form allowing any residual balance not paid by your insurance company to be applied to the credit card on file. After 30 days we will apply the remaining balance to your credit card even if we have not received insurance payment.
- For preventive services, we will file your insurance and wait for the “assignment of benefits” from your insurance company for up to 30 days. We require a signed “Signature on File” authorization form allowing any residual balance not paid by your insurance company to be applied to the credit card on file. After 30 days we will apply payment to your credit card even if we have not received insurance payment.
If you have questions regarding your account, please contact us. Many times, a simple telephone call will clear any misunderstandings. Please remember you are fully responsible for all fees charged by this office regardless of your insurance coverage. Any remaining balance after your insurance has paid is your responsibility.