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Financial Policies

We would like to take this opportunity to welcome you to our office and assure you that we will do our utmost to provide you with the best care possible.

Download our Financial Policies Form

Patients With Insurance Coverage: We will be glad to help you obtain the appropriate benefit from your insurance carrier and bill your carrier as a courtesy to you. However, you are ultimately responsible for payment of the account should there be a discrepancy with your carrier.

We will be happy to request a pre-estimate of benefits from your insurance carrier if you request us to do so. Routine treatment is generally performed without submitting a request for pre-estimate of benefits. Please note that most insurance plans provide an alternate benefit equal to a silver filling for a white filling in a back tooth with the patient responsible for any difference in fees.

Portions of the bill may not be paid by the insurance company and are to be paid by the patient. Often there is a co-payment required by you as per your insurance agreement. With crown and bridgework, as well as dentures, we require this to be paid before the work is sent to the laboratory for processing. Even if you have dual insurance coverage, there may still be a balance after all insurance payments have been received.

Patients asking for X-Rays taken in our office to be transferred to another office will be charged a $25 duplicating fee.

Patients Without Insurance Coverage: Patients without insurance coverage are required to pay for services when rendered. We accept cash, check, Visa, MasterCard and Discover.

Additional Terms: Appointments cancelled with less than 24 hours notice are subject to a $44.00 cancellation charge. Please be courteous to other patients as well as our office in this matter. Checks returned by your bank are subject to a $30.00 processing charge.

Accounts unpaid after 30 days from the date of billing are subject to a finance charge at the rate of 1/2% per month. If your account is referred for collection, you will be responsible for collection costs in the amount of 33% of the outstanding balance plus court costs and reasonable attorney’s fees.