We are required by applicable federal and state law to maintain the privacy of your health information and want you to know we take the privacy of your confidential protected health information very seriously. We use and disclose health information about you for treatment, payment, and healthcare operations. We will not use your health information for marketing communications without your written authorization.
COMMITMENT TO APPOINTMENT POLICY
We reserve time for each patient in our practice, and rarely do we ever keep our patients waiting. An appointment written in our schedule with your name on it is a bond of trust that we will be here to serve you and you will be present for that appointment. You are expected to arrive on time for your appointment to avoid having to be rescheduled in order to keep the next patient from waiting. We do not allow cancellations or short-notice changes and reserve the right to charge if made less than 24 hours in advance. (We do not accept recorded messages as appointment cancellations or changes.) We must have mutual respect for each other’s time, therefore our office policy in this regard is extremely firm and inflexible.
COMMITMENT TO FINANCIAL AGREEMENT
We believe we have a responsibility to use our best professional care, skill, and judgment in planning for your dental treatment. Payment is due at the time service is rendered unless other arrangements have been made in advance. All fees will be explained to you, and you agree to fulfill your financial commitment to the office promptly and completely. We will assist you in receiving benefits from your dental insurance; however the fees in our office are your responsibility. No business or practice can fulfill its mission to its patients when a bond of trust is violated by failure to pay for services.
You agree you are fully responsible for all fees charged by this office regardless of your insurance coverage. We welcome all traditional dental insurance that allows you to go to the dentist of your choice, since we will be considered out-of-network. PLEASE UNDERSTAND that your insurance is a contract between you and the insurance company and our fees may be in excess of the Usual, Customary, and Reasonable (UCR) determined by your insurance company. You understand that you are responsible for any balance on your account after 60 days, whether insurance has paid or not. If your insurance company denies your claim for any reason it is your responsibility to pay the denied amounts in full.