ALL appointments that are canceled under two business days will result in a $100 fee.
All NO SHOW appointments will incur a fee of $100.
Our goal is to provide high quality care to our patients and respect their schedule as well. In fairness to other patients, and the office staff, we require advanced notice when changing or cancelling an appointment.
When you schedule an appointment, we reserve that time and prepare in anticipation of serving you. If you should need to reschedule, we kindly request that you contact us with advanced notice. We understand that conflicts arise; however not coming to your scheduled appointment time or canceling without adequate notice will result in a charge of $100.
Patients who continue to no-show and/or cancel without notice may be dismissed from the practice and asked to find another dentist.
Any patient who is more than 10 minutes late may be considered a “no show” for their appointment and may need to be rescheduled.
As with any dental treatment, there may be unforeseen treatment adjustments and/or complications. The clinic will make an effort to anticipate any changes in the treatment plan and advise me at that time. However, such events are unpredictable. Likewise, the timing or spacing of appointments may need to be modified as needed to accomplish the best result possible.
DiCicco Dental Studio is Out of Network with your Insurance.
You will be financially responsible for the services you receive at DiCicco Dental Studio. If you have dental insurance with out of network benefits, we will submit all services you receive at DiCicco Dental Studio to your insurance company in order for your insurance to send you a reimbursement. If you request an estimate of coverage for the procedures you are receiving prior to your visit, please keep in mind this is only an estimate of the reimbursement you will receive as quoted to our office by your insurance company. It is your responsibility to make sure your insurance is active the day of your visit. It is also your responsibility to notify our office if your insurance changed prior to your visit to confirm that your new insurance has out of network benefits. Please inquire at the front desk any questions additional quesitons you may have about your insurance and how fees are collected.
Our office requires a credit card hold which is secured in our system.
DiCicco Dental Studio requires a credit card hold for all patients receiving treatment.This information is secured in our system. You will be notified prior to being charged for services or prior to being charged a cancellation or no show appointment fee.
By signing below, I have read, understand and agree with the policies instituted by DiCicco Dental Studio.