6968 Warner AveHuntington Beach, CA 92647Office Phone: 714.842.5593Email: firstname.lastname@example.orgOffice Hours:Monday thru Thursday8:00 AM - 5:00 PMFriday8:00 AM - 2:00 PM
We would like our patients to be informed of our office financial policy. We are comitted to providing you with the best possible care. If you have dental insurance we are anxious to help you receive your maximum allowable benefits. In order to achieve these goals, we need your assistance and your understanding of our financial policy.
We accept cash, personal checks, MasterCard, Visa, American Express, and Discover. In addition, we offer an excellent third party financial payment plan for balances over $1000.00. Our office staff would be happy to provide you with more detailed information on this plan if you are interested. Returned checks and outstanding balances older than 90 days may be subject to finance charges at the rate of 1.5% monthly.
If you have dental insurance, you must bring proof of insurance and we will be more than happy to submit your insurance claims for you. However, you must realize:
You may direct the insurance company to pay their share of the cost directly to our office (Assignment of Benefits). Often, we do not receive these payments until two to four months after being submitted for payment; therefore, we do ask that you pay your estimated share at the time treatment is rendered. Upon receipt of the insurance payment, we will reconcile your account and bill or refund any differences.
We must emphasize that as dental care providers, our relationship is with you, the patient, not your insurance company. While filing the insurance claims is a courtesy that we extend to our patients, all charges are your responsibility from the date the services are rendered. We realize that temporary financial problems may affect timely payments of your account. If such situations do arise, we encourage you to contact us promptly for assistance in the management of your account.
We respect your time and ask that you respect ours by honoring your appointment commitment. A broken appointment is a loss to everyone. Remember, once you have made an appointment, this time is reserved for you. Please give us at least 48 hours notice if you are unable to keep your appointment. This will allow us to accommodate the needs of other patients more readily. If we do not receive a cancellation notice within 48 hours, a cancellation fee may be applied to your account.
If you have any questions about the above information, please do not hesitate to ask us. We are here to serve you.
Or Email Us at email@example.com
We look forward to hearing from you!