Dental Office Rules & Policies

 

1. All patients who are over 18 years of age must show their picture ID.

 

2. If applicable, co-payments must be paid at time of visit.

 

3. All patients must show their current Dental Insurance Card.

 

4. Patients must have their current health information with all prescribed medications.

 

5. We accept cash, check, VISA, MasterCard, and Discover. Payment of your “estimated” portion is due at the time services are rendered, such as your annual deductible and/or percentage of the treatment not covered by insurance. We will contact your insurance in order to provide an “estimate” of your patient portion. However, despite this, we cannot guarantee the payment of insurance benefit nor can we provide 100% accuracy of this estimated amount since many factors are involved that determine the actual payment of benefits once submitted and processed by your insurance.

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Non-Discrimination Policy: It is the policy of the Dental Studio to not discriminate in the provision of services to an individual because the individual is unable to pay; because the payment for those services would be made under Medicare, Medicaid, or the Children’s Health Insurance Program; or against any individual on the basis of race, color, religion, ancestry, national origin, citizenship status, age, sex, marital status, genetic information, sexual orientation, gender expression, gender identity, non-disqualifying disability or veteran/military status in matters of admissions, employment, or services.  Discounts are available based on family size and income.  All staff members are fully committed to function in accordance with all applicable federal, state and local laws regarding non-discrimination.

 

6. All dental services rendered, whether or not covered by insurance, are ultimately the financial responsibility of the account holder. We will give your insurance company 60 days to remit the payment. If there is still no payment after this time, you will be financially responsible for 100% of the outstanding insurance claim. A statement will be sent to you, and payment in full will be due on the due date printed on the statement. It is the responsibility of the account holder to follow up with their own insurance company regarding the non-payment of a claim. Should our office receive payment from your insurance after it has been paid by you, a prompt refund will be issued.

 

For All Appointments

 

1. It is your responsibility to remember your appointment time. However, we will remind you with a courtesy call.

 

2. If you must cancel, you must call at least 24 hours before your appointed time. If our office is not contacted there will be a "No show" Dismissal Letter sent. We take your and our time very seriously and have a strict appointment policy.

 

3. If you change your phone number, please call and provide our office with the new number.

 

4. On a Saturday our office is open, any broken appointment will result in not being able to see you for 1 year on a Saturday. 

 

5. There is a $30 charge for all returned checks

 

6. If you are going to be more than 10 minutes late, then please call and let us know. We can not guarantee there will be enough time for all of treatment planned for that specific appointment, but will try to accommodate to the best of our ability. If need be, we will reschedule your appointment.

 

Children under 18 will not be seen unless accompanied by a parent/guardian.