Thank you for choosing us as your dental care provider. We are committed to you treatment being successful. Please understand that payment of your bills is considered part of your treatment. The following is a statement of our Financial Policy which we require you read and sign prior to any treatment. All patients must complete our Registration Form before being seen.

Payment is due at the time of service. We accept cash, checks, Visa, Mastercard, American Express and Discover.

Financial arrangements may be made when extensive dental care is needed (Please see the receptionist for more information.)

Regarding Insurance:

We accept most insurance companies. We cannot bill your insurance company unless you give us your insurance information. Your insurance policy is a contract between you and your insurance company. We are not a party to that contract. In the event that your insurance company should deny payment for whatever reason, after every effort is made by our office to receive payment, the balance becomes the patient responsibility after 45 days. Please be aware that that some, and perhaps all of the services provided may be non-covered services and not considered reasonable and necessary under your dental insurance.

Regarding Insurance Plans where we are a participating provider. All co pays and deductibles are due at the time of treatment. In the event that your insurance coverage changes to a plan where we are not participating providers, refer to above paragraph.

Adult Patients/Minor Patients

Adult patients are responsible for co-payment at the time of service. The adult accompanying a minor and the parents (or guardians) are responsible for co-payment. For minor accompanied by other family members, non-emergency treatment will be denied unless charges have been pre authorized to approved credit card or payment by cash or check at the time of services and a note from patient/guardian stating that we can treat patient. Minors under the age of 18 years can not be treated unless a family member with note from parent or parent/guardian is present.

Missed Appointments

Unless you cancelled, at least 24 hours in advance, our policy to charge for missed appointments at the rate of $25 per one hour or less scheduled. In the event that the appointment is over one hour you will be charged accordingly. Our office has a voicemail that is on 24 hours a day, please call as soon as you know you cannot make a reserved appointment we check messages often. Please help us serve you better by keeping reserved appointments.

Confirmation calls are a courtesy. We make every effort to contact you at the numbers provided. In the event that we can not reach you by phone, it is still your responsibility to keep reserved appointments.

Time is important to both you and our office. We try our best to stay on time and with you help we can. For this reason if you are running behind and cannot get to your appointment one time, please contact office prior to coming to see if there is still time to complete your treatment. If you arrive 15 minutes or later you will have to rescheduled.

Office Hours

Our hours are by appointment only. The office hours are as follows:

* Only some Saturday appointments are available, see front desk for more details.

HIPPA The Health Insurance Portability and Accountability Act

We also enclose a copy of our privacy policy and by signing this office policy you acknowledge receipt of this document in your new patient packet or if your a patient record, this will be update your current record.

Thank you for understanding our Financial and Office Policy. Please let us know if you have any questions are concerns.