Financial Policy Effective October 12, 1998



Financial Policy


Balance is due the day service is rendered and may be paid either by cash, check, or credit card.  If you are unable to pay your balance in full you may set up arrangements with our financial secretary.  Accounts not paid on the day services are rendered will receive a finance charge of 18 % annually or 1.5% per month.



Financial Policy For Patients With Insurance


Insurance is a contract between the insurance company and the patient, NOT the dentist.  The patient is responsible for all charges for dental care.  You should be aware that dental insurance is NOT designed to pay all of the cost of treatment, your dental insurance form, your deductible and percent not covered by insurance will be due on the day of service.  If you have questions regarding your coverage, please ask a member of our business office staff and we will work with you to find the answer.


I have read and understand these policies.


_____________________________  Date_____________