We know that providing comprehensive dental services include discussing all treatment and financial information. Before treatment is performed, we will discuss treatment and financial options. This will help you to fully understand your dental treatment, what to anticipate in fees and allow you time to make the necessary financial arrangements.
We are a fee-for-service provider, which means that payment is due at the time of each service and collected at the end of every appointment. We do not participate with any dental/medical insurance plans and are considered an out-of-network provider. However, you may still be eligible for out-of-network benefits from your insurance carrier based on your plan. We can provide you with an insurance claim form that you submit to your insurance carrier.
Accepted methods of payment:
- All major credit cards
- Checks (there is a $35 fee for any overdrawn or insufficient funds)
Appointments are reserved exclusively for you. We reserve the right to charge and collect $225 for any broken hygiene appointments and 50% of the treatment for any restorative treatment appointments. Broken appointments are considered those that are missed (no-show) or cancelled with less than 24 hours advance notice.
Financial Policy Form
Our office limits the number of patients we see each day to ensure a high level of quality and care during their treatment with you. We prepare for your appointment well before you enter our office. This is why last minute cancellations significantly impact our office and our ability to provide support to other patients hoping to work with us. Therefore, in order for us to reserve a place in our schedule for you, we require that you agree to our last minute cancellation policy as follows:
- You must provide at least 24 hours notice if you need to cancel or change your appointment. This means that if your appointment is scheduled for 2pm Wednesday, you have until 2pm sharp on Tuesday to change or cancel. We strictly adhere to this time boundary.
- If you miss appointment time, you will be charged $225 for hygiene appointments and 50% of the fee for any restorative treatment appointments.
- Our appointment confirmation and reminder emails are a courtesy. Not receiving either of these does not make a last minute cancellation exempt.
- Unexpected events can and do occur in one’s schedule. We understand that things like illness, work emergencies, delayed flights are out of your control, but they are also out of our control – so they are not exempt from our last minute cancellation policy.
- If you are late more than 20 minutes for your hygiene appointment, your appointment may be considered cancelled. It is difficult for our hygienists to rework a treatment plan into less than the original scheduled time. Please call our office if you are going to be late so we can determine if rescheduling is necessary.
- In order to schedule, you must provide a credit card number to be kept securely on file. In the event of a last minute cancellation, you agree that this card on file will be charged.
Office Policy Form