Patient Info
| First Visit |
You are here either because you are in pain, you are aware of some problem, or because you want to have a routine "clean and check" appointment. If you are in pain, that will be treated. In either of the latter two instances a thorough examination will be done, and if indicated, further x-rays and diagnostic procedures will be recommended. |
| Treatment Plan |
Your treatment may be "phased" into priorities; i.e., that treatment which is necessary just to maintain your mouth without further deterioration (Phase I), a stage of rebuilding procedures (Phase II), and final approaches to your own level of optimum health (Phase III). If you ever have any questions concerning your treatment, please do not hesitate to ask. No treatment will be undertaken until WE agree on a course of action. |
| Financial Policy |
In the interest of better understanding, we believe financial arrangements must be completely understood and agreed upon before definitive treatment is begun. Your treatment will be explained to you and you will be given an estimate of fees. Please ask questions of any staff.
Unless other arrangements are made, dental treatment fees can be handled in one of the following ways. We ask you to let us know which option you prefer:
2. Pay the estimated co-payment the day of service, if you have dental insurance. 3. Financing through the preferred customer account which allows ninety (90) days "same as cash" with minimum payments. To receive this free service, a revolving charge agreement must be set up with our staff. A late charge of 1 1/2% per month, 18% annual, will be added to the unpaid balance after 30 days, unless financed otherwise. |
| Insurance |
Many people now have some form of dental insurance. We will be happy to file any forms necessary to help you obtain maximum reimbursement from your insurance company; however, a few points must be fully understood.
2. Your insurance company may base its allowances on a fee scale which may or may not coincide with our office fees; moreover, almost every dental plan has a provision for limiting funds expended for covered services, and reimbursement is rarely 100%. 3.Many insurance carriers require a "pre-authorization of treatment". If your company does so, we will be happy to submit your treatment plan for prior approval; a process which sometimes requires several weeks to complete. 4. In some instances it may be possible to determine before hand what your benefits will be, in other instances it will not. Please understand, however, that even though we will handle the paperwork for you, we are not responsible for the structuring of your plan. This is a pre- determined situation agreed upon by you and the insurance carrier; therefore, if you have any questions in regard to dollar disbursement, or what your plan will consider a covered charge, you must refer these questions to your insurance carrier or your employer. 5. If your insurance company has not paid within the 30 days from the date your form is filed, it will be your responsibility to pay the balance or have a late service charge as out lined in our financial policy. |
| Appointment Cancellations |
We make every attempt to be on schedule. Your appointment time is reserved for you. If you must cancel an appointment, we appreciate a 24 hour notice. |
| Emergencies |
Time is held daily for urgent care. If you have a problem, please call early in the day to schedule your most convenient time. |
| Referrals |
We gladly accept new patients. If this office is a good experience, tell a friend who might appreciate a similar experience. If this office is a bad experience, tell us so that we may improve. |
| Thank You |
Thank you again for selecting us. If at any time you have questions regarding any treatment, fee, or service, please discuss them with us promptly and frankly. We will make every effort to avoid a misunderstanding and to preserve a friendship. |