In an attempt to keep your medical costs to a minimum, we have adopted the following policy regarding payments and billing. If you do not have insurance coverage or assignable insurance, payment is due in full on the day of service. For your convenience, we accept Visa, MasterCard,Carecredit, cash or a check drawn from a local bank. There is a $25.00 fee for a returned check.
For patients with DENTAL insurance plans, we require that you pay any deductible or co-payments at the time of surgery or when services are rendered. A minimum of 30% will be required on the day of service.
We are providers of the following Dental Insurance:
- Delta Dental
- Anthem Blue (100, 200, 300)
For patients with MEDICAL insurance having a MEDICAL procedure (for example, a biopsy) we require that you pay any deductible or co-payment at the time of treatment. A minimum of 30% will be required on the day of service.
For patients with MEDICAL insurance having a DENTAL procedure (for example, wisdom tooth removal) we require payment in full at the time of service. We will be happy to file your insurance claim for you.
Please contact your insurance company’s information office to determine how you might be reimbursed or covered for a service provided in our office.
ALL ACCOUNTS MUST BE PAID IN FULL WITHIN NINETY (90) DAYS from the date of service. This amount is your responsibility. We will submit your insurance claim to your Primary insurance companies as a courtesy to you. After 90 days, your outstanding balance is due regardless of the status of your insurance claim. If processing of your claim has been delayed we request your assistance in expediting the process.
Please be sure to read your insurance booklet and forms carefully. If you are in doubt as to whether your procedure is covered, please check with your insurance carrier.
We will send you a monthly statement. Most insurance companies will respond within four to six weeks. Please call our office if your statement does not reflect your insurance payment within that time frame. Any remaining balance after your insurance has paid is your responsibility. Your prompt remittance is appreciated.
If you have questions regarding your account, please contact Courtney or Saundra at (765) 446-8808. Many times, a simple telephone call will clear any misunderstandings.
We will ask you to sign a financial responsibility statement reflecting acknowledgment and understanding of this policy at your initial office visit.