Thank you for choosing our office for your endodontic needs. We realize that every person’s financial situation is different. The following information is provided to avoid any misunderstanding or confusion concerning payment for professional services. To maintain the practice operations, we ask patients to accept and adhere to the following financial arrangements regarding their dental treatment. Our practice firmly believes that a good doctor/patient relationship is based upon open communication. Please contact our office at any time with any questions. We make every effort to be available to clarify any questions you may have concerning your payment. We hope to possibly avoid any misunderstanding over payment for professional services. Dental treatment is an excellent investment in an individual’s medical and psychological care. We are always available to answer your questions or assist you in any way we can.

Payment Options:

1. Insurance Billing: We will file your insurance claim, which will be paid to our office. The patient is responsible to pay his/her portion of the treatment the day of care. You may pay with cash, check or credit card. Your portion will be determined and explained to you prior to having any treatment initiated. We have a credit card on file policy for your portion due.
2. Care Credit Option: We offer our patients, upon approval, an interest-free term loan (up to 12 months) with no down payment, no annual fee, and no pre-payment penalty. Please ask for an application.

After Hours/Weekend Emergencies: In the event of an emergency after regular business hours, a $95 emergency fee will be charged in addition to the necessary treatment fees.

Credit on file Card Policy

We have implemented a new, convenient payment policy using Credit Card on File. With the current fluctuations in dental insurance policies, co-pays, deductibles and in vs out of network plans, we have implemented this policy to make it easier on you and us. You will be asked for a credit card at your initial visit, and this information will be held securely. The amount that we will charge the credit card on file will be the financial responsibility that the insurance company requires you to pay.

What are the benefits to me?
Patients with a credit card on file will no longer have to worry about statements and mailing in payments. You can also use it for future appointments without having to bring your card.

How does this work?
During your initial visit, we will ask you to sign a “Credit Card on File Agreement”. When our office receives payment information from your insurance company (typically 2-4 weeks), any remaining portion of charges will be charged to your credit card. A receipt will be mailed or emailed to you after the payment has processed. If the payment is declined, we will charge an additional $25 fee and will request an updated credit card or an alternative form of payment.

What if I don’t have a credit card?
We also will accept Debit cards, Health Savings Account (HSA) cards or Flex Spending Account (FSA) cards. If you do not have any of these, we will require payment in full at the time of service and you will be reimbursed after Insurance has made their payment.

What if I want to keep my appointment but I don’t want to sign the credit card on file agreement?
You will be required to pay in full at the time of service. Your insurance will be submitted and once they have paid, you will be refunded the overpayment by check. We can estimate what your charges will be for your upcoming appointment so that you’re prepared to pay prior to being seen the day of your appointment.

How can I be assured that my credit card information will remain safe?
Under HIPAA, we are under strict state and federal rules and guidelines to protect patient privacy and the credit card is considered protected health information. Get Beyond, our credit card processing vendor, will store your information on a secure and encrypted site, which will enable to run card transactions through our computer system. None of our employees will have access to your card information.

I have never had to this at any other dentist’s office.
This may be different from what you have been used to, but it is becoming common practice in most dental and health care facilities with the changes that have come about in the insurance industry. This policy is being implemented in order to simplify your experience. It will also lower the practice’s administrative expenses.