Financial Information

Basic Policy

Payment for services rendered is due in full at the time of service. Our office accepts cash, personal checks, and credit cards.

Surgery Fees

Surgical procedure fees are due prior to your surgery. Your insurance carrier may require prior authorization.

For Patients with Insurance

As a service to our patients, we bill insurance on your behalf. Payments are due at the time of service; the ultimate responsibility for any unpaid balance rests on you. Please understand that insurance is a contract between you and your insurance company, we are not contracted with medical/dental insurance policies. If an insurance carrier has not paid within 60 days of billing, any unpaid professional fees are due and payable in full from you.

Medicare Patients

Medicare does not cover tooth extractions or oral surgery except in rare occasion. Our patients will be given documentation to assist in submission for their claim. If Medicare denies payment, you are responsible for charges.

Non-Covered Charges

Any charges not paid by your insurance carrier will require payment in full at the time services are provided or upon notice of insurance claim denial. 

Workers Compensation

If your injury is work-related, we require the necessary insurance billing information and employer authorization form prior to your office visit or treatment.

Personal Injury Cases

This office does not accept liens nor bill for auto-accident or other liability or lawsuit-related cases. The patient is responsible for services provided at the time of service.

Follow-Up Visits

Periodic post-operative office visits may be required by the attending doctor to monitor your health.

Cancellation of Appointments

Our goal is to provide high quality of care at low cost to our patients and in fairness to other patients and the doctor, we require at least 24 hours’ notice when canceling an appointment. 

Explanation of Fees

Your fee for service includes your visit with the doctor and any treatment provided. In addition, proper attention to your case requires that the doctor spend more time working for you outside your direct visit with him or her. Such time may include:

  • Creation of a permanent medical record.
  • Review of prior and current x-ray or scan reports.
  • Preparation and mailing of consultation reports and follow-up visit letters and laboratory/scan results to referring doctors and any subsequent consulting.
  • Phone consultation with referring or consulting practitioner and other health care providers about your case.
  • Other phone calls to and from you and your family members for various reasons.
  • Referral letters to any further specialists recommended by the doctor.
  • Staff assistance regarding your visit.
  • Arranging and coordinating other tests and consultations.
  • Insurance application forms: medical/dental, disability, and life insurance.
  • Insurance reports: health claims, disability claims to insurance and state, Medicare disability.
  • Discussions (sometimes acrimonious) with hospitalization utilization review, insurance companies, or Medicare for ongoing hospitalization.
  • Letters of necessity for medical services to insurance companies.
  • Other reports and forms: jury duty, school, job, sick leave, back to work, etc.