Our Financial and Cancellation Policy

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Thank you for choosing Canyon Park Dental. We realize that everyone has a choice in their dental providers and we are honored you have entrusted us in our office to care you and your family.

FINANCIAL POLICY

For our patients with Insurance

Dental insurance has become more complex than it has ever been in the past. To cut costs, employers are changing dental insurance policies frequently. Insurance providers vary, even within the same insurance company. We encourage you to review your policy in detail prior to your appointment so you are aware of your plan specifics and to avoid any financial surprises. All questions about your coverage, including remaining health benefits, should be directed to your insurance company.

It is imperative that we are aware of any changes to your insurance prior to your appointment. If for some reason we are unaware of a change, unfortunately, you will be responsible for the entire amount. Once we receive your insurance information, as a courtesy, we will resubmit the claim to your new plan and have any benefits sent directly to you.

Please remember, your insurance policy is a contract between you and your employer

We will estimate and assist you in determining your insurance health benefits. However, there are several factors that can affect the estimate. There may be a deductible, or you may have received treatment at another office prior to joining our office. We can make no guarantee of any estimates given by our office or your insurance company. Any percentage not covered by your insurance is due at the time services are rendered. If for any reason the estimated amount is not paid by your insurance company, you will be responsible for the remaining balance.

Separate Households

In instances where there are two households dividing the financial responsibility, any and all payment arrangements must be made between those parties involved exclusive or Canyon Park Dental.

Payment Options

  • As of January 2015 - We will be collecting what Insurance will not be helping with for services rendered
  • Credit Cards: Visa/MasterCard/Discover/American Express
  • Outside Financing: CARECREDIT - For transactions of $300.00 or more, we are able to offer our patients a third party interest free line of credit. Applications are available from our Patient accounts coordinator, Evie Martin.

For all billing questions, please contact our Patient Accounts Coordinator: Evie Martin @ (425) 877-1138.

CANCELLATIONS

A scheduled appointment is a commitment of time between you and our practice. We have reserved the time just for you. When appointments are missed or cancelled short notice, that time is permanently lost. If you find you cannot keep your scheduled appointment, we request a minimum notice of 24 business hours. Failure to do so may result in a $100 per hour misses appointment fee. We understand emergencies occur and we will always take that into consideration.

From the date of this agreement, each family member is entitled to 3 short notice cancellations or missed appointment in the life of the relationship with the practice. After 3 missed appointment, our office will visit you to determine if your dental needs may be best served at another office more conducive to your schedule. If we both should choose to continue our relationship, you may be asked to prepay all future appointments.

If you have any questions, please don't hesitate to contact us. We sincerely appreciate your understanding and cooperation in our desire to establish and maintain a strong healthy relationship.

I have read and understand the terms and conditions of this Financial and Cancellation policy form set forth by Canyon Park Dental.


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