Thank you for choosing our office for your dental needs. We are committed to providing you with quality dental care in a comfortable and friendly atmosphere. We believe dental treatment is an excellent investment in an individual’s overall well-being. Sensitive to the varying needs of different people in fulfilling their financial obligations, we provide a number of payment options. We would like to acquaint you with our financial terms, which are intended to facilitate exceptional dental service.
PAYMENT OPTIONS – Full payment is expected at the time of treatment using one of our convenient payment methods. These include dental benefits, cash, check, credit card or CareCredit. For those without dental benefits, a bookkeeping discount of 5% is given for payment in full by cash or check at the time of service. Our office sparingly sends out statements.
- Full Payment is due at the time of service.
- We accept payment by cash, check, credit card, CareCredit and most insurance plans.
- We provide insurance billing as a convenience to our patients. The patient portion of any particular dental service is estimated and due at the time of service.
- We are a preferred provider for a growing number of dental insurance companies.
DENTAL INSURANCE – Dental plan benefits are determined by a negotiated contract between your employer and an insurance company and we are not a party to that contract. As a courtesy to you, we are happy to file your dental benefit claims and assist you in maximizing these benefits. Most plans are intended to assist with the cost of treatment and seldom offer truly full coverage. Since our office cannot guarantee individual insurance payments, the patient is responsible for verifying their benefits and for any amount that is not paid by the policy. We’ll do our best to use our experience to help you through it. We will estimate the covered portion and will assist you in determining your responsibility for treatment. Any portion that is not covered by insurance is due by you at the time of service.
If for any reason the estimate was incorrect, we will send you a statement for the remaining balance or a credit for overpayment. Please call our office if your statement does not reflect your insurance payment and we will be happy to check the status of your claim. We encourage you to review your policy so you are aware of your plan specifics.
PARENTS – The adult who accompanies a minor to an appointment is responsible for payment on the day of a minor’s treatment using one of our convenient payment options. If the minor will be coming alone or with a caregiver, please make arrangements with our office in advance. The adult(s) who signed the new patient forms will receive billing statements for any additional fees that are due.
MULTI-VISIT TREATMENT – If a crown, bridge, denture, partial or other prosthesis is to be fabricated by a dental laboratory, a 50% deposit is required at the time of the first impression. The remaining balance is due when the prosthesis is inserted.
EMERGENCY VISITS – Emergency patients who are new to the practice are expected to make payment at the time of treatment.
CANCELLATIONS – Our providers reserve your appointment time exclusively for you. We kindly request a 24-hour notice to cancel or reschedule an appointment.
COLLECTIONS – If a collection agency becomes involved in the settlement of your account, all collection costs and legal fees for both parties are the responsibility of the account holder.
MEDICAL ASSITANCE/BADGERCARE – Our office does not accept Medical Assistance. Fond du Lac County residents with Medical Assitance/BadgerCare and no other dental coverage should contact Save-a-Smile at 920-929-3085 to determine eligibility and for further instruction. A screening is required before you will be referred to an appropriate dental provider.
We realize that temporary financial situations may affect timely payment of your account. If such a problem should arise we encourage you to contact us before treatment for recommendations on the management of your account.
If you have questions regarding your account or to learn more about payment options including CareCredit please call our knowledgeable, experienced staff. Many times, a simple phone call will clear up any concerns.
With our convenient payment options,
you can have the smile of your dreams today.