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Payment
Options:
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Visa,
Master Card, AMEX, Cash, and Check
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No Interest
payment plans (12 month) &
Extended Payment Plan
Financial Policy
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In the
event of returned check an additional amount of $25 for processing will be
charged
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Balances
older than 60 days may be subject to collection fees and finance charges at
the rate of 18% annually
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All
Medical/Dental records and X-Rays are properties of this office and any
costs to transfer to another practitioner will incur a duplication fee of
$30. Administration time to return records, and other documentation is
between 2-4 weeks.
Co-payment / Insurance
Coverage
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We are signed up with Major Dental Insurance
Companies. (i.e. Delta Dental, Metlife, Cigna, Aetna, Guardian, Principal,
Anthem Blue Cross, SafeGuard, etc.)
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All estimated co-payments are due when services are rendered. We
will provide you with an estimate of your co-payment prior to or during your
visit.
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Our office
will not enter into a dispute with your insurance company over any claim,
although we will provide necessary documentation your insurance company
requests to sort out any confusion or questions that may arise. It is
ultimately your responsibility to resolve any type of dispute over payments
made or not made by your insurance company.
48 hr Cancellation
Policy
There will be
$50 per hour fee for any missed
or broken appointments without 48-hour prior notice. I also understand that the
cancellation of scheduled appointment for Dental Cleaning may result in having
to miss a regular three, four, or six-month appointment.
If you have
any questions regarding your insurance benefits call
(925) 939-9177
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