1. You understand that what we charge, and what your insurance pays, very well may be very different. Our fees are in many cases higher than what many insurance companies consider as "reasonable or customary." This is mainly because we limit the number of patients we schedule in any one day in order to provide a more personalized service to our patients. In order to see fewer patients, our fees must be higher than the fees of dentists who see more patients. Thus, if your insurance company says they will pay 80% on a filling, they really mean they will pay 80% as long as the fee isn't more than a certain dollar amount, or as long as it is a silver-mercury filling. They may actually pay much less than 80% on one of our bonded tooth colored fillings.



2. You agree that the charges you incur here are your responsibility regardless of what your insurance company pays on your bill.



3. You agree to pay your bill in full (via credit card on file) if your insurance company has not paid within 30 days. You understand that your insurance company may ask for additional information. We will provide this information upon receipt of a fee which we will charge to your insurance company. If this type situation happens, it is very unlikely that payment will be received within 30 days, in which case you agree to authorize us to charge your credit card for any outstanding balance regardless as to whether or not your insurance company has received the information they have requested.



4. You understand that we will not be responsible for knowing the various scenarios in which your insurance does not pay for whatever reason. Such scenarios include such things as pre-existing conditions, waiting periods, x-rays which can only be paid on every so often, less costly alternative provisions, required pre-authorizations, etc. Your insurance company may use these and other reasons for avoiding payment of your claim. We will not be responsible for knowing these various intracacies of your particular insurance contract. You will need to be responsible for knowing all these details and advising us if this is important to you.

If you do not wish to leave a credit card on file, we will help you set up an interest free account (of up to one year interest free) with one of the several outside financing agencies with whom we work. Then, when you come to our office, you won't pay us. Rather the outside agency will pay us, and when your insurance company reimburses you, you can pay off your debt with the outside financing agency without incurring any interest charges.