Our Practice Financial Policy
Our practice is dedicated to providing you with the best possible care and service. We regard your understanding of our financial policies as an essential element of your care and treatment. To assist you, we have the following financial policies. If you have any questions, please feel free to discuss them with our staff.
- Your treatment plan is individually tailored based on the doctor’s comprehensive evaluation of subjective and objective clinical and radiographic findings, as well as thorough evaluation of your history and reported symptoms. The treatment plan is not based on your insurance benefits or lack of benefits.
For Patients without Insurance
- Payment is expected at the time of treatment
- We accept cash, checks, credit cards (MasterCard, Visa, American Express) and Lending Club.
- For all services rendered to minor patients, the adult accompanying the patient is responsible for payment
For Patients with Insurance
- We do not accept any DHMO plans
- We are network providers for Aetna, Cigna, Delta Dental and Guardian
- We accept most other PPO plans Out-of-Network if they are based on UCR (Usual and Customary Rates). We make every attempt to verify your eligibility and benefits for you prior to the appointment as a courtesy. However, payment from the insurance company is never guaranteed. It is your responsibility to ensure that you are eligible for benefits at the time of service.
- Although we file claims for you as a courtesy, your dental insurance policy is a contract between you, your employer and your insurance company. Not all services are covered benefits in all contracts. Some insurance companies arbitrarily select certain services they will not cover. It is your responsibility to thoroughly understand the coverage and exceptions of your particular policy. Coverage issues can only be addressed by your employer or group plan administrator. We cannot act as a mediator with the carrier or your employer.
- We will always do our best to help you maximize your benefits when needed.
- We will do our best to give you a rough estimate of your out-of-pocket expenses based on your insurance coverage and remaining benefits. All estimated co-payments are due at the time of service.
- We will bill the insurance directly for the remaining balance, but because payment by the insurance company is never guaranteed, you will be responsible for any balance remaining in the event of a claim denial. You will receive all copies of the Explanation of Benefits from your insurance company. Please review these statements carefully, and let us know of any errors or discrepancies.
For everyone, our goal is a positive clinical experience, while still maintaining reasonable fees for the first-class service we provide. Any final co-payments will depend on the insurance coverage you have independently selected or purchased. Please note that most insurance plans only partially cover white fillings or aesthetic white crowns. Co-payments are common for these procedures. Co-payments or charges for any uncovered services will be collected on the day of the service. Final insurance payments may take months to fully process, and may be different from co-pay treatment estimates our office creates. Sometimes this requires financial adjustments be made months after an appointment.
Missed Appointment Policy
Your time is important, and we will be ready to serve you at a mutually agreed upon day and time. Unlike many medical and dental offices, we do not double book our schedule. This allows you to receive focused and attentive care, but requires everyone be on time.
We value the relationships we have with our patients and strive to do everything we can to accommodate your schedule. We ask for your cooperation in helping us provide you with the best care by arriving on time to your scheduled appointments. Patients arriving more than 15 minutes late to a scheduled appointment may be asked to reschedule. We feel that decreasing your appointment time affects the quality and predictability of our care.
Please notify us 48 BUSINESS HOURS IN ADVANCE if you need to cancel and/or reschedule your appointment. Failing to do so will result in a MISSED APPOINTMENT FEE OF $100 for any reason, including sudden illness, traffic, or forgetfulness. We devote our time and focus our efforts on serving your needs. This pays for a portion of the staff and office space we have reserved for that patient. If you are unable to make your appointment, please allow us this 48 business hour window so that we may provide care to others. Repeat offenders will be required to prepay for all treatment including any potential missed appointment fees prior to rescheduling. Additionally, a patient who breaks the first office appointment with us is invited to pursue a relationship with another dental office. Exceptions will be made for large scale natural disasters, such as earthquakes and city-wide power outages.
We will make every effort to send you reminders prior to your appointment. If you need to make any changes, you can do so by responding to any one of our reminders, or contacting us at (415) 515-4694 or via email at firstname.lastname@example.org.
We thank you for your cooperation in advance and look forward to providing you with the best quality of care. If you have any further questions, please feel free to ask. Hopefully you agree that these rules are fair, and remind all of us to treat each other with basic courtesy and respect.