Promenade Dentistry Insurance and Financial Arrangements
Our staff would like you to know that we are committed to providing you with the best care possible. In order to achieve this goal, we are in need of your assistance and understanding of our financial policy in the following areas:
INITIAL VISIT/CONSULTATION - As a courtesy we will bill your insurance company, provided you furnish the office with a completed insurance claim form or insurance card. You may be responsible for a deductible and the percentage that your company requires at this visit. If you are having future treatment we would appreciate if you pay this bill in full and apply your payment toward the estimated portion of your future visits. If you do not have dental insurance, it is customary in our office to pay in full at the time the appointment is made.
TYPES OF PAYMENT - Cash, checks, and Visa/MC/Discovery/American Express are accepted. It is customary in our office to pay for services when appointments are made. We do offer various payment plans, and if you wish, our front office concierge will discuss them with you. We realize that from time to time, temporary financial setbacks may affect timely payments on your account. If such problems do arises, we encourage you to contact our office for assistance in the management of your account.
INSURANCE - Our practice is committed to quality care for our patients and we charge what is usual and customary for the area. Please also realize that not all services are a covered benefit in all insurance policies. Your insurance is a contract between you, your employer, and the insurance company. You are responsible for payment in full regardless of any insurance company's determination of usual and customary fees. We require payment of your estimate portion of treatment when it is performed, unless other financial arrangements have been made. Should a problem arise regarding payment from your insurance carrier, you will be notified and a portion or payment is required within 30 days.
REFUNDS OR OVERPAYMENTS - We issue monthly or by special request.
INTEREST CHARGES/ ACCOUNTS REFERRED TO COLLECTIONS - Accounts not settled in 90 days are subject to a 1.5% interest charge, on any unpaid balance, which computes to an annual rate of eighteen percent (18%). In the event your account is referred to collections an additional charge of $25.00 will be added to your outstanding balance.
WORKMEN'S COMP OR ACCIDENT - This must be approved before patient may receive services or patient pays in full.
CANCELLATION OF APPOINTMENTS - We require at least 48 hours notice of cancellations for scheduled appointments. Short notice or failed appointments may result in charges since we are budgeted for time allotted. Patients that are late may have to be rescheduled as we try very hard to be on time for our other scheduled patients.
Our staff is here to assist you achieve the treatment you desire and deserve. They will gladly discuss your proposed treatment and answer your questions regarding services, payments, and insurance. Again, please do not hesitate to ask for assistance in any of the areas above.
