Disclaimer

Please Review Your Dental Plan Carefully

It is important to understand the exclusions and limitations of your dental insurance plan before proceeding with any treatment. The following points outline our financial policies and what you can expect regarding billing, insurance coverage, and appointment commitments.

Insurance & Co-Pay Information

• We expect your co-pay (any amount not covered by insurance) at each appointment.
• If we cannot precisely determine the co-pay, an additional invoice may be sent for the remaining balance.
• If you have two insurance plans, we will submit claims to both on your behalf.
• Depending on your plan limits, you may still have an outstanding portion to pay.
• We strongly encourage patients to request estimates for all services beforehand.

Understanding Insurance Limitations

• Benefits are a contract between your employer and the insurance provider.
• Most policies do not cover 100% of treatment costs.
• Your insurance pays based on the premiums you or your employer contributes.
• Lower premiums typically mean lower coverage amounts.

Patient Responsibility

• Due to privacy laws, insurance companies release detailed information only to the policy holder.
• This includes any treatment you may have received at other clinics. It is your responsibility to know the specifics of your insurance plan.
• We can help check your coverage prior to treatment, but these are estimates—not guaranteed amounts.

Billing & Payment Policy

• We direct bill your insurance company as a courtesy.
• If insurance does not pay within 45 days, we may request full payment from you.
• You will need to collect the reimbursement directly from your insurance provider.
• All overdue accounts will incur interest charges.
• If your insurance conditions change, you must notify our staff immediately.

Appointment & Cancellation Policy

• We reserve specific appointment times exclusively for you. We strongly encourage all patients to keep their scheduled appointments.
• If you must cancel or reschedule, we require at least 2 business days’ notice to avoid fees.
• Without proper notice, a cancellation fee of $50–$100 will be applied, depending on the appointment type.
• This fee must be paid before scheduling any future appointments.
• In rare cases of repeated missed appointments, we may only offer same-day scheduling.