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Patient Financial Policy

Payment is due at the time services are rendered. For your convenience we accept cash, Visa, MasterCard, Discover, money order, registered check and most personal checks.

We view your dental benefits as an entity that financially assists you with your dental care and finances. Your dental benefits are based on a contract between your employer and the dental benefits company. As a courtesy we will be glad to file your claim for you if you bring 1) your dental benefits wallet card and 2) all required employer information. You will be expected to make full payment for services rendered. Once we verify dental benefits status we will, as a courtesy, file the claim on your behalf. We will request that the benefits check is sent directly to you or if payment received in our office will forward the check directly to you. The total balance for the day’s appointed treatment is considered due and collectible from you upon arrival for the appointment.

We reserve the right to charge and collect fees for broken appointments – (appointments that are cancelled or broken without 48-hours advance notice.) There will be a charge of $55.00 per ½ hour of appointment time reserved for your dental appointment. Appointments are reserved exclusively for you. As a health benefit to you, we may offer to move your appointment to an earlier time if openings arise.

A Returned Check Fee, Closed Account Fee or Frozen Account Fee of $35.00 will be added to your account balance and is collectible. This must be resolved before proceeding with further treatment regarding this account.

Delinquent Accounts must be resolved prior to scheduling further appointments. We reserve the right to charge collection fees, attorney fees, and all court fees to accounts forwarded from our office.

Payment plans and financial arrangements can be entered into for comprehensive dental treatment, prior to commencing treatment. We offer Care Credit and Med-Direct for extended financing terms.

I have read and understand this financial policy.


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