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Our Forms and Policies Appointment Policy We have just a few Appointment Guidelines: 1)If you arrive late for your appointment, we will make every effort to see your child. In certain situations, we may have to reschedule your child to be able to be fair to our other scheduled children. 2) If you need to reschedule your appointment, please give us at least a 24 hour notice. There is a fee for an appointment missed without giving us a 24 hour notice. Don't forget to call us if your plans change. THANK YOU! 3) If you need to reschedule a "MONDAY" appointment please do so by 5pm on the THURSDAY prior to your Monday appointment. We are closed on Fridays. Our Payment Policy The parent bringing the child to our office is legally responsible for payment of all charges. We cannot send statements to other persons. All financial arrangements are made directly with you. The following alternatives are listed as a guide for possible financial arrangements:
Dental insurance: There is no direct relationship between our office and your insurance company. Your insurance benefits are determined by the type of plan selected by you and/or your employer. As such, we have no say in the selection of your insurance company, the determination of your insurance benefits or the method of reimbursement. Therefore, we do not accept assignment of benefits from your insurance company. Any reimbursements by your insurance company should be made directly to you according to the terms of your contract with them. We will provide you with the necessary forms to facilitate reimbursement to you from your insurance carrier. Pre-treatment authorization: Some insurance companies request a copy of our dental treatment plan before determining their benefits to you. If so, we will provide you with the treatment plan and fee estimates. Emergency treatment: All emergency treatment must be paid in full at the time care is rendered. Your cooperation with our payment policy is greatly appreciated. If you have any questions, please ask us.
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