We are delighted to welcome you to our practice, and are pleased that you picked us to be your dental provider. Our goal is to provide you and your family with optimal dental care. We want you to feel welcome and as comfortable as possible throughout our relationship, and we encourage you to ask questions and to be involved in your treatment decisions. This includes understanding your treatment plan, as well as our financial policy.
Clients are expected to pay for our services at the time they are rendered. If you have dental insurance, you are expected to pay the amount of your estimated co-pay and deductible at the time of service. Payments may be made using cash, check, or credit card. We can also refer you to CARECREDIT and PROSPER HEALTHCARE if you would like to explore healthcare financing options. We will mail monthly statements to all patients with an outstanding balance charge of 18% per annum after 90 days.
All of our doctors will diagnose treatment based on your dental health, not your insurance coverage.
In order to provide the best possible service, we try to maintain an efficient appointment system. The cost of doing business greatly increases when people fail to keep their scheduled appointments or cancel at the last minute. We now require at least 24 hours notice for any cancelled appointment, and reserve the right to charge a $50.00 fee for any missed or cancelled appointments. We understand that there are some circumstances that cannot be avoided, but kindly do your best to notify us accoringdly so that we may make alternative plans.
Dental insurance is not technically "insurance". Insurance is an arrangement in which a company provides compensation for a specified loss or damage (think car insurance). In actuality, dental insurance is a money benefit, typically provided by your employer to help you pay for routine dental services. Your employer will buy a plan based on the amount of the benefit, and how much the premium costs per month. Most benefit plans are only designed to cover a portion of the total cost of an individual's necessary dental treatment.
For Example: Your dentist may recommend a crown for a tooth that has extensive decay, however, your dental plan may only cover the cost of an amalgam (silver) filling. This does not mean that you do not need a crown, only that your benefit is limited to a filling.
As a courtesy to you, we will file and submit your insurance claims free of charge. We will help you receive your maximum allowable benefits. Please note that your dental insurance may not cover all procedures.
If your insurance has not paid within 90 days of services rendered, you will need to make full payment to this office and will be reimbursed if / when your insurance company pays. After 90 days, you are responsible to pursue payment from the insurance company, and we are happy to provide any supporting documentation that you may need for reimbursement.
Please read the following
I understand that all co-payments are due at the time services are rendered.
I understand and agree that Dental Design SD does NOT represent my dental insurance carrier, and CANNOT make any representation or warranty that my dental insurance carrier will cover all or any portion of the dental services provided by this office.
I acknowledge that it is my responsibility to determine whether or not a dental service procedure or treatment program is covered by my dental insurer.
I acknowledge that is is my responsibility to know what my insurance covers and what my remaining benefits are.
I understand that if my insurance does not pay within 90 days of services rendered, payment for any outstanding balances will be due. I will be supplied with any suppporting documents in order to support reimbursement claims.
I understand that I will be refunded for any overpayments made.
I understand that any statements made by the Dental Design SD staff concerning my insurance is made in good faith, and cannot be relied upon as a guarantee of coverage.
Please indicate your understanding and acceptance of these financial policies by signing below