First Visit

First Visit

Patient Form Medical History Update Notice of Privacy Practices
Payments Accepted:	Check Cash MC/VISA Care Credit (Financial Arrangements)
Insurance Information:	Our office will gladly file dental claims electronically to your primary insurance carrier. We are not a "participating" or "preferred" provider in any network plan. We can not guarantee a set payment by your insurance company, but can give you an estimate since this is a contract between you and your insurance carrier. We can assure you that we will do our best to provide your insurance carrier with the necessary information to process your claim and maximize your benefits. The patient is responsible for any balance not paid by the insurance company. Interest will be charged on all accounts 60 days old at 1.5%/month.
Calling to Make 1st Appointment:	When calling to schedule your first appointment, please have your dental insurance information ready. our front office staff will need: the carrier name, address, phone number, group/ID number, member's name, birthday and social security number. We will be happy to verify your insurance before your scheduled appointment. This allows you to pay your "estimated" portion instead of payment in full. Please note the patient is responsible for any balance not paid by the insurance company. If you do not have dental insurance please refer to our list of "payments accepted".