Dental Forms
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Sleep Apnea Forms
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Insurance
Our team is here to help you understand and receive your benefits from your insurance. We will gladly file your insurance as a courtesy to you. We ask that you pay the difference of the amount due and estimated insurance coverage at the time of your appointment.
Financial
Our financial policy was designed to give you a number of payment options to choose from in order to make your payment as easy on you as possible. We accept cash, check, credit cards (Visa, MasterCard, or Discover), or pre-approved extended payment plans such as CareCredit. Payment is due at the time services are rendered unless prior financial arrangements have been made.
If you have a financial concern, please do not hesitate to contact us to discuss your unique situation.
Cancellations
We require 48 hours advance notification if you are unable to keep your appointment. Failure to do so will result in a cancellation fee of $50.00 for every 30 minutes of reserved time or $100 per hour.
Minor & divorced couples
The parent who accompanies a minor for treatment is responsible for any payments or outstanding balances at the time of appointment for services, regardless of primary insurance policy holder.
Service Charges
For those patients with an unpaid balance over 60 days, we may add a 1.5% per month service charge onto the balance. For accounts past due 90 days, the patient will be responsible for all collection cost, court cost, and attorney fees related to collecting the unpaid balance. Please understand that you are responsible for the balance due on your account as a result of any and all professional services rendered by this office, regardless of your insurance status.
Misc. Fees
There will be a $35 fee for a check that is returned for any reason.
No work will be completed unless the balance is paid in full at time of delivery.