We would like to extend a warm welcome to you, and we thank you for choosing our practice for your dental care needs. Our goal is to provide the best care possible, and to provide excellent preventive dentistry to help our patients keep their teeth for a lifetime by offering state of the art technology, equipment, facilities and professional staff.
To promote maximum care and establish a healthy relationship with our patients, we have instituted the following policies in our dental offices:
Appointments are scheduled during regular office hours. A courtesy call will be placed 24 to 72 hours in advance as a reminder of the appointment scheduled. It is imperative to keep your scheduled appointments and to be on time. Arriving late or missing an appointment reserved for you will result in rescheduling of your appointment. A cancellation fee of $100.00 will be assessed if the proper 24-hour notice is not given to our office during business hours. Appointment times are extremely important. Missing appointments results in lost time that could have been used by another patient.
We will gladly assist you by filing your insurance claim and maximizing your insurance benefits. You are required to pay your deductible and estimated copay before treatment is rendered. Co-payments are only estimated percentage costs, which may be subject to change once the claim is processed and paid by your insurance carrier. By signing below, you agree that any portion of a claim balance or benefits not paid by your insurance becomes your responsibility to pay.
Children under the age of 18 are considered minors and must be accompanied by a parent or authorized adult, as required by state law, to their appointment in order to be treated. At the time of service, parents/authorized adults are to wait in the lobby until called to consult with the dentist. This protects the privacy of patients in other operatories and assists in keeping all staff, patients and visitors safe according to OSHA guidelines.
Unless other arrangements have been previously made, payment is expected at the time of service in the form of cash, check, credit card (MasterCard/Visa/Discover/American Express) or Care Credit. As a courtesy to qualifying patients, payment options are available and can be arranged with the office manager. All checks will be verified and electronically processed. If for any reason you default on a payment plan, your account will immediately be turned over to the Judicial Court System for collection.
Any returned checks will incur a returned-check fee of $25.00 and must be paid in our office by cash, cashier’s check, or money order within 5 business days after contact by our office manager. If you do not comply after we have contacted you concerning your check, all of your information will be turned over to the Worthless Check Department at the Judicial Court System. You will be responsible for all additional charges and legal fees necessary to collect any unpaid balance.
It is our pleasure to add you to our family of patients and look forward to serving you and your family. We are extremely dedicated to providing our patients with the highest quality care in a warm, caring environment.