Patient Resources

Patient Resources

Welcome to Our Practice

Thank you for choosing **practice-name** for your dental needs.

We strive to provide a comfortable environment where you'll feel confident in the level of dental care you receive. When you arrive for your first visit, please be prepared to complete all insurance and health information forms that will allow us to begin your dental treatment. We will ask you to fill out several forms that will get you acquainted with our office.

New Patient Forms

Our New Patient Forms are now available online so that you can complete them at your convenience, giving you time to carefully review our policies and procedures without having to do so at our office. Click on the link below print the forms and bring them to your first appointment.

Payment Options

We are committed to providing dental care that is both high quality and affordable.

Payment options include cash, checks, Visa, MasterCard, American Express, In-office Discount Plan, major or participating Insurances, and CareCredit. We accept the credit cards pictured below.

If you would like to extend payments over a longer period of time, we offer CareCredit. Click on the CareCredit logo for more information.

Visa Discover
Master Card CareCredit

Patient Loyalty Program

Patient Resources

**practice-name** is pleased to offer our Patient Loyalty Program for patients who do not currently have dental coverage. This plan allows our patients to receive optimal dental care while maintaining their oral health.

Dental Services Included:

  • 2 Cleanings (prophy or periodontal maintenance)
  • 2 Fluoride applications for children under 14
  • X-rays as needed
  • 2 Dental Examinations
  • 20% Discount on all other services

Advantage of Patient Loyalty Program:

  • No deductibles
  • No waiting periods
  • No claims to file
  • Immediate enrollment
  • Caring, Comprehensive, Quality dental work

Provisions of the Patient Loyalty Program:

  • May not be combined with insurance plans, discounts or promotions
  • Program is not transferable
  • Benefits are provided for one year from the enrollment date
  • Annual fee is due and to be paid in full when starting program
  • If CareCredit is used to pay for program, only a 10% discount on services will be given
  • If a credit care is used to pay for services, only a 15% discount will be given
  • Must pay for treatment in full on date of service

Insurance Options

Patient Resources

Our office is committed to helping you maximize your insurance benefits.

Because insurance policies vary, we can only estimate your coverage in good faith but cannot guarantee coverage due to the complexities of insurance contracts. Your estimated patient portion must be paid as per the contract agreement.

As a service to our patients, we will bill insurance companies for services. If you have any questions, our courteous staff is always available to answer them. If your insurance covers orthodontic treatment, you will receive the benefit of reduced personal costs. Many insurance policies have a lifetime orthodontic benefit that is distinct from regular dental insurance. Insurance policies vary, so we will review your insurance to determine the appropriate course of action.

Once treatment has started, we will file your claims. To help us with your insurance filing, please complete the insurance questions on our New Patient Registration Forms. **practice-name** accepts most insurance plans. Please have your insurance information accessible when scheduling your first appointment - that way we can verify your insurance benefits and minimize your out-of-pocket expense! If your plan requires a dentist referral, please obtain one before scheduling your complimentary consultation to avoid treatment delays. Please bring your insurance card and information to your consultation appointment.