At Simply Smiles Dentistry, we are committed to providing our patients with the highest standards of dental care. Our doctors will always recommend what is in the best interest of our patients' oral health. We will strive to make your experience in our office positive and pleasant. In order to achieve these goals, and focus on your care, we need your assistance in understanding our financial policy.
1. Patients are responsible for payment of their bill on the day services are rendered. For your convenience, we accept Visa, MasterCard, Discover, American Express, Apple Pay, CareCredit, checks, and cash as forms of payment.
2. We require a 48 hour notice to reschedule or cancel any appointments in our office. If you no-show or cancel your appointment without notice, we reserve the right to charge you for the missed appointment at the rate of a normal office visit. We respect your time and appreciate your understanding that the doctor reserves time in her schedule specifically for you when in our office.
3. If you are paying out of pocket for your dental treatment, ask about the Simply Smiles Discount Plan. We can also offer 5% off your diagnosed treatment if you pay for all services in full at the time of scheduling. The only exception to these discounts are products and medication including, but not limited to, in-office dispensed premedication, arestin, orthodontic night guards, and whitening trays. The prepay discount is not able to be used with any other discount that we offer including CareCredit and in-network insurances.
Patients with insurance(s) need to understand that our primary focus is always the healthcare of our patients. Our recommendations on maintaining your oral health will always be based on what is in your best interest, and not what your insurance chooses to cover or not cover. We understand that you hope to receive all the dental insurance benefits to which you are entitled, and we will do our best to help you do so. We are considered an "out-of-network" provider and will accept assignment of benefits, file, and track your PPO dental insurance for you as a courtesy.
1. If insurance benefits are assigned to Simply Smiles Dentistry, you will be responsible for paying your deductible and/or estimated patient portion at the time services are rendered. You are responsible for paying all charges not covered by your insurance company, including fees considered above your insurance's usual and customary fee schedule.
2. We are happy to help you receive the maximum benefits available under your policy. As a courtesy, we will file your insurance benefits for you after every visit. However, please realize that the relationship is between you (the insured) and your insurance company. If we do not receive payment from your insurance company within 30 days after submission of the claim, you will be expected to pay for any and all completed dental services in full. We will contact you by phone/email for any payments due.
3. We are not responsible for knowing various scenarios in which your insurance chooses not to cover service (ie: frequency limitations, waiting periods, substitution/downgrading of procedures, etc). We will only recommend what is in your best interest.
4. If you prefer to pay your estimated patient portion and not the full fee, we require a credit card to be kept on file. If you prefer to not leave your card on file, you are welcome to pay in full for services rendered and we will file your claim for you; in which case any insurance reimbursement will be sent back to you.
I acknowledge that I have read, understood, and agree to abide by the financial policies of this office: