FINANCIAL POLICY

Patient’s with Dental Insurance: Patient’s with dental insurance are required to pay their co-pays and deductible at the time services are rendered. We will make our best effort to calculate your co-pay.
Please keep in mind it is only an estimate and we base all of our calculations on your insurance plan.

Every insurance policy has variations; if we overestimate or underestimate your co-pay we will: credit your account, issue you a refund or bill your account for the balance.

ULTIMATELY IT IS THE RESPONSIBILITY OF THE PATIENT TO PAY IF INSURANCE DOES NOT.

Patient’s without insurance: Payment is expected in full at the time services are rendered.
The following methods of payment are accepted: Cash, Check, Visa, MasterCard, Discover.

CANCELLATION POLICY

The appointment you made is especially reserved for you. We require a minimum of 48 hours notice for any appointment changes such as cancellations or rescheduled appointments. A fee of $50.00 will be charged to your account if 48 hours notice is NOT given. If you fail to show for your scheduled appointment and neglect to give a courtesy call a fee of $50.00 be automatically be charged to your account. Repeat cancellations and/or no shows will result in an automatic charge equivalent to the amount of services that were to be provided at that reserved appointment. We will require pre-payment after 2 consecutive cancellations and/or no shows, prior to scheduling another visit.


I have read the financial and cancellation policies and agree to both