Welcome to our practice! We are excited to have you as a lifelong patient. It is our goal to provide you with the highest quality of dental hygiene care in a courteous and effective manner. In order to achieve this goal, we ask that you read and agree to the following practice policies:
APPOINTMENTS – Our practice is dedicated to quality care and exceptional service. Our team spends extensive amounts of time preparing for your visit. Broken and missed appointments create scheduling problems for our team as well as other clients. If you find that you must change your appointment, we require a minimum of 48 hours notice so that we may make every effort to accommodate other clients. If proper notice is not received, a fee of $50.00 will be charged for every hour of allotted time cancelled to your credit card on file.
TREATMENT – Our primary goal is not to allow the cost of treatment to prevent you from benefiting from the quality care you need or desire. In our practice we strive to maximize your insurance benefits and make any remaining balance easily affordable. Our fees are based on the quality materials we use and the time, effort and skill required in performing your needed treatment. We charge what is usual and customary for the service area. We will assist you with your benefit eligibility before treatment to help you calculate your costs and maximize your insurance benefits. We will be sensitive to your financial circumstances and do everything possible to help you achieve optimal oral health. Ultimately however, you are responsible for payment regardless of any insurance companies’ arbitrary determination of usual and customary rates (UCR).
The insurance policy is an agreement between you and the insurance company; we ask that all patients be directly responsible for all charges. We are happy to submit the claims necessary so that you receive the full benefits of your coverage; however we cannot guarantee that the estimate of coverage will be reimbursed in full. Please know that we will do everything possible to see that you receive the full benefits of your policy by filing your claim the day of your appointment so that your insurance company will reimburse you directly in a timely manner. If there are any complications, we will assist you with any information you may need.
FINANCIAL POLICY – Payment for services is due at the time services are rendered unless prior arrangements have been made. For you convenience, our practice accepts the following forms of payments: cash, check and most major credit cards. If you choose to pay by check, and it is returned to our office for any reason from your financial institution you are subject to a $35 returned check fee, in addition to the returned check amount. This fee covers the processing fees that are charged to our office. Should your account become delinquent for more than 60 days, a finance charge of $50 or 5% per month will apply, whichever is greater. If your account should be referred to an attorney or collection agency, the undersigned shall be responsible for all additional fees incurred in the collection process.
We would be happy to discuss our charges and how they relate to your particular situation. We also realize that temporary financial situations may affect timely payment of your account. If such problems do arise, we encourage you to contact us promptly for assistance in the management of your account. Most often, financial misunderstandings can be managed with a phone call. Please feel free to contact our wonderful staff at any time to discuss any concerns you may have.
Dental Hygiene Direct 