These financial guidelines assist in creating financial arrangements for our patients and are approved for use when offering patients financial options. Any financial arrangements outside these guidelines must be approved in writing by management.

Fees

• We charge all patients fees based on our usual and customary fee schedule or contracted fee schedule if the office is in-network with the patient’s insurance. Fees are carefully set and updated to reflect the quality of our work and the costs associated with delivering a great outcome.

Discounts

• We carefully set our fees and are happy to explain the recommended treatment plan and the associated fee in detail and in advance, so we never have to apologize for the quality of our work.
• Pre-pay discount: The patient may receive a 5% courtesy discount if payment for the entire treatment is received at the time the treatment is accepted and scheduled.

Payment Timing

• To be put on the schedule all Doctor or Hygiene treatments require one of the following:
  • Payment in full includes a 5% pre-payment discount
  • Half the payment portion (other half paid before their appointment)
  • 3^rd Party Financing Approved Agreement

Payment Timing When Using Insurance

• Estimated patient portion and co-pay is due when a Doctor or Hygiene treatment is scheduled.
• Insurance claim is to be submitted the same day treatment is rendered. If the insurance pays on seat date, claim is filed on the seat date.
• If insurance payment is not received within 30 days, the patient should be contacted for payment.
• Credit card on file: We keep a credit card on file for all patients utilizing insurance in our secure, PCI-compliant online system. If insurance does not pay or the amount is different than the estimated patient portion, the patient is notified of the amount and the card on file is charged.

Payment Options

• MasterCard, Visa, American Express, Discover
• Debit
• Cash or Check
• Apple Pay, Google Pay
• Refer to the “50 Ways to Pay” resource sheet for ideas on how patients can pay for treatment.

Third-Party Financing

• We have a relationship with the following three patient financing companies:
  • HFD – Preferred (1st choice)
  • Cherry – 2nd choice
  • SunBit – 3rd choice
  • CareCredit – 4^th choice
• We offer financing only after the patient asks for it or if it is clear they will need a financial option other than paying directly for treatment.

Easy Pay Form

• We always use the EasyPay form for presenting financial arrangements. We do not use the practice management software-generated treatment plan when presenting financial arrangements.

Payment Plan Before Treatment Begins

• If the patient does not qualify for third-party financing, you may offer the option of the patient making payments in advance of the treatment beginning. 100% of the fee must be collected before treatment begins.

Minor Patients

• The adult accompanying a minor and the parents (or guardians) are responsible for full payment. We will not treat unaccompanied minors unless prior approval and financial arrangements have been made in writing.

Past-Due Balances

• Past-due balances are collected at the beginning of any appointment before any additional treatment is rendered.

Credit Balances

• Patient credit balances are applied to the patient portion for treatment being scheduled.

Write-Offs

• Write-offs are limited to a maximum of $100. Anything above $100 needs doctor approval.
• Any insurance claims that are returned as not covered or denied are usually the patient’s responsibility to pay. Otherwise, doctor approval is required if they are going to be written off.