Financial Office Policy

Please correct the errors described below.

The following information is to inform you of our financial policy. If, at any time, you have questions regarding this policy please do not hesitate to ask any member of our business team.

We are committed to providing you with the highest quality of care. Our fees are a reflection of the quality of care we provide. We continue our commitment by offering a variety of financial options to enable you to receive the dental care you need. We accept cash, check, VISA, MasterCard, Discover. We have also partnered with a third-party company to offer the flexibility of deferred interest and extended payment plans. Check policy: If your check is returned for any reason, we will electronically debit your account for the amount of the check plus a processing fee of $35.

We will communicate all recommended treatments option and associated fees, prior to the start of treatment. Payment is expected at the time of treatment. A delinquent account impedes our ability to provide you with the quality dental care that you deserve. It is our policy that the parent or guardian who accompanies a child to our office for treatment is responsible for payment of all services rendered.

We are committed to respecting your time and ask that you make every effort to keep the appointment time reserved exclusively for you. We understand there may be times you are unable to keep your scheduled appointment, however, any appointment missed may be subject to a missed appointment fee $45. Should you find it necessary to reschedule an appointment, please provide us with a notice of two business days to avoid being charged a missed appointment fee.

As a courtesy to you, we will be happy to bill your insurance company and work with you to maximize your benefits. Please remember that the financial obligation for your dental treatment is between you and this office. All outstanding balance not paid by the due date will incur a monthly finance charge with 14.99% interest. Outstanding balances over 90 days will be forwarded to an outside agency for collection. These accounts will be subject to a collection fee of up to, but not limited to 35%. No question is too small for you to ask, whether it is about your treatment, benefit or statement. We are here to help you.

My signature indicates that I have read and understand the above information.

Your information will be encrypted.