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Our Financial Policy

Full Payment is due at Time of Service
We accept Cash, Checks, Visa, MasterCard, Discover, and Care Credit

We are committed to your treatment being successful. Please understand that payment for services performed is considered a part of your treatment. The following is a statement of our Financial Policy, which we require that you read and sign prior to any treatment. Also, all patients must complete our information form before seeing the doctor. These forms and more can be found in the Patient Information section of our web page.

Regarding Insurance

Insurance is a contract between you and your insurance company. We are not a party to that contract. We are not a participating provider for any dental or medical insurance company due to the nature of our specialty practice. We will be happy to provide you with the necessary documentation that will enable you to submit for any reimbursement that you are entitled to. We are not a Medicare or Medicaid provider and are unable to file any claims to them.

Usual And Customary

Our practice is committed to providing the best treatment for our patients and we charge what is usual and customary for our area. You are responsible for payment regardless of any insurance company’s arbitrary determination of usual and customary rates.

Minor Patients

The adults accompanying a minor and the parents (or guardians of the minor) are responsible for full payment.

Homestead Act

We are not a party to divorce decrees. Adult patients are responsible for their bill on the date of initial treatment. In the cases of a minor patient, the accompanying adult must pay the bill. We are not a party to bankruptcy claims filed.

Missed Appointments

Unless cancelled at least 2 working days in advance, we consider it to be a broken appointment and we reserve the right to charge for missed appointments at the rate of a normal office visit. Please help us serve you better by keeping scheduled appointments.

Finance Charge

A finance charge will be imposed to your account if a balance has not been paid within (30) days. This will be computed at the rate of one percent (1%) each month with the annual rate of twelve percent (12%).

Returned Checks

There is a bank fee of $40.00 for any returned check by the bank. There will also be a handling fee of $25.00 for any returned checks.

Telephone Calls

To the provider for a medical discussion will be charged as follows: 5-10 minutes $25.00, 11-20 minutes $50.00, and 21-30 minutes $75.00.

Payment Options

  1. If you decide that you would like to pay the full amount at the initial appointment, we will write off 4% of the total, if paid in full by cash, check, or money order. Debit cards are not accepted with this offer. This is only honored if the amount is $1,500 or more.
  2. Payment can be made ½ at the initial appointment and ½ at the insertion appointment. This can be paid by cash, check, money order, Visa, MasterCard, or Discover.
  3. Another option is many local banks will offer excellent financing options. (ex. Essix Bank 804-784-4000)
  4. Care Credit: This is a payment option that we offer through an outside company. We participate in the 6 Months No Interest Plan and the Extended Payment Plans (amount over $1,000). The extended payment plans have a corresponding fixed Annual Percentage Rate of 14.90% interest, however; if the payment is late they will charge an additional fee.

If you need an application for Care Credit we will be happy to provide one. They have made it very convenient to apply over the phone or online. or 1-800-365-8295

If you have any questions please feel free to give us a call 804-282-0510.

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