Welcome to our practice and thank you for choosing us as your child’s dental health care provider. We wish to advise all new parents of our policies and procedures to prevent any misunderstanding regarding our services.
- Please provide us with any previous medical records to ensure complete medical care.
- At your initial visit you will be asked to complete a registration form. This form is to be updated when any changes occur to your insurance or personal information.
- You will be asked to present your insurance card at each visit.
- Payment of co-payments and non-covered services is expected at the time of service.
- If a co-payment is not made at the time of the appointment, a $10.00 fee will be charged to your child’s account.
- We will file a claim with your insurance carrier. Any amounts that are denied or unpaid will be billed to you.
- In divorce situations, the adult accompanying the child is responsible for payment at the time of service. The parent with whom the child resides is the parent who will be billed for services rendered. We cannot become involved in mediating financial arrangements between parents.
- Our fee for returned checks is $35.00. If two returned checks are received within any period of time, we reserve the right to request future services be paid with cash or credit card.
- Our appointment times are limited. Therefore, we have an established fee for missed appointments. Our charge is $15.00. Please call within 24 hours of the scheduled appointment to cancel.
We look forward to serving your child’s health care needs. If you have any questions regarding these policies, please contact our office manager, at (412) 538-0010