1. INSURANCE: As a convenience to you, our office will submit claims to your insurance carrier, but the patient or guardian is responsible for the account. Copayments will be estimated and are due at the time a procedure is performed. The patient is responsible for furnishing the correct insurance information. Should an insurance policy pay benefits directly to the subscriber or patient, payment for under such contract will be due in full at the time of treatment.
2. PAYMENT OPTIONS: Monthly payments are available through CareCredit, MasterCard, and Visa are accepted.
3. CANCELED OR MISSED: There is a charge of $100 per half hour for canceled appointments with less than two business days notice or missed appointments.
4. FINANCE CHARGE: At a rate of 1% the past due balance is assessed a finance charge and the charge is added to the account balance. The minimum charge per month is $1.00.
5. RETURNED CHECK: There is a $50.00 returned check charge. The amount of the check plus the check charge must be paid with a credit card or in cash.