The following payment policy enables us to provide the service we do:
- Payment is due at the time of service.
- 5% billing service discount is provided for payment in full before or at the time of service. Payment can be in cash, by check, or by a major credit or debit card. The office accepts Visa, Mastercard, AmEx, and Discover card payments. (The billing service discount is available to patients with dental insurance only if they pay in full at the time of service and receive reimbursement from their dental plan. The office can assit with documentation and the preparation of claim forms.)
- For patients with insurance, the office accepts assignment of benefits, however the estimated patient portion or co-pay is due at the time of service. The patient, parent or responsible party agrees to receive a statement of account and agrees to pay immediately the balance that remains following receipt of any third-party payment. Likewise, any credit balance that accrues as a result of third-party payment will be reported in the next regular billing statement and, upon request, will be refunded immediately.
- Patients who qualify for alternative payment arrangements may choose one of the following options:
- 90-day-no interest financing: Payment of at least 1/4 – 1/2 the amount at the time of service and payment of the remaining balance in three additional installments 30, 60 and 90 days of the date of service.
- Six month financing with interest: In-office financing over a six month period with interest at 18% per year (1.5% per month) applied to any account balance that remains after the first 90 days.
- Automatic payment plan: The office can set up an automatic recurring payment plan in select situations.
- Alternative financing: The office also facilitates patient financing through Care Credit, which provides no or lower interest over a longer payment period. The office is also a participating provider with the Citi Health Card program that enables easy financing for qualified patients.
Questions about payment arrangements or third-party dental plan coverage should be directed to Loni at 801-262-1974 or firstname.lastname@example.org.