Elk Plaza Dental Eric Hunter, DDS
FINANCIAL POLICY AND CONSENT
Our staff is happy to help you select the payment method best suited to your financial situation. We have options including convenient credit or cash discounts. Fees for new patients’ initial examination and any emergency treatment are payable on the day of service. For patients who have dental insurance coverage, only the ESTIMATED portion will be due at the time treatment is rendered. If a balance remains after your insurance has made their payment, a statement/bill will be sent to you.
We offer the following payment options: • Cash, Check, Money Order • Visa and Mastercard credit cards • 3-month payment plan option – Your 1st payment is due on the day of service • CareCredit for patients who want a payment plan extending beyond 90 days (subject to credit approval) • We offer 5% savings for UNINSURED patients who pay in full with CASH or CHECK on the day of service • Senior Discount – 10% savings for uninsured patients who pay in full with CASH or CHECK on the day of service
PLEASE NOTE: THERE WILL BE A FINANCE CHARGE OF 1.5% ADDED TO ALL ACCOUNT BALANCES OVER 90 DAYS PAST DUE
Most dental insurance plans do NOT cover 100% of your dental treatment. Your ESTIMATED portion is due at the time treatment is performed. Your dental benefits policy is an agreement between you and your benefits provider, and not between your benefit plan and Elk Plaza Dental. We cannot guarantee any estimated portion or preauthorized coverage. If your claim is paid less than anticipated or denied altogether, you will be sent a statement of the remaining balance, due within 30 days. If your insurance company has not paid on your claim(s) within 30 days, it is your responsibility to contact them by phone or online to find out the reason for the delay. Sometimes, they are waiting for a response from you, or need further information from our office.
Missed appointments inconvenience our office and other patients who may have been urgently trying to get in to see the doctor. Starting November 1, 2018, there will be a cancellation fee of $50.00 applied to your account for a missed appointment which was not canceled at least 24 hours in advance. If another appointment is missed, a $75.00 charge will be applied. Missed appointments longer than 75 minutes will incur a $100.00 fee. These fees are your responsibility, and cannot be submitted to your insurance. I acknowledge I have read this financial policy and agree that, by signing below, I acknowledge responsibility for all terms and conditions contained herein.