Other family members that are patients here : |
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Insurance And Financial Information |
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Financial Policies |
We offer 5% discount to all patients that pay IN FULL by cash or check for ALL SERVICES/TREATMENT before at the time of service.
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It is each patient responsibility to make a determination if they have active insurance coverage.
Patients that receive treatment and later find out they are not active are responsible for the full amount of services provided.
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We service over 200 different insurance policies. It is impossible for us to determine the amount that the insurance company
pays for services and if the insurance company will pay at all.
Insurance reimbursements estimates are just that, estimates.
We do not guarantee payment amount or payment at all.
Please be aware we are an insurance friendly office and will go to great lengths to see that you are reimbursed
by your insurance company but we do not guarantee any reimbursement or amount of reimbursement.
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For patients who choose to have us bill insurance and are unwilling to pay the full amount at the time of service,
and would rather wait for reimbursement, we require a credit card on file in the event that the insurance company fails to pay
or insufficient payment is received. At the receipt of insurance reimbursement and explanation of benefits the patient will be
informed that the remaining balance will be placed on their card before the card is charged.
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We work with all insurance companies, when you arrive our office will be happy to do a complimentary benefits check for you,
we will bill the insurance for the patient after the service is started/completed.
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In the event that an insurance company overpays or pays the amount to us when it is owed to the patient we will reimburse
the patient within 2 business days.
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In the unfortunate event of failure to pay outstanding bills in a timely manner we will reserve the right to turn the amount
over to a credit agency and/or withhold services.
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ACKNOWLEDGEMENT OF RECEIPT OF: Privacy Practices Notice and Dental Material Fact Sheet |
This document acknowledges that you have received or declined a copy of: |
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Notice of Privacy Practices
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Dental Material Fact Sheet
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This document is not a contract, authorization, release or consent form. This document will remain in your records.
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