Financial Information


Our goal is to provide the highest quality of oral and dental care possible and to have clear communication of our financial policy.


American Express

USUAL AND CUSTOMARY RATE (UCR) Our practice is committed to providing the best treatment possible for our patients. Our fees reflect the usual and customary rates for our area. Keep in mind that the rates paid by your insurance carrier are determined by the insurance carrier and your employer and, in some situations, have no bearing on the actual usual and customary rates charged in the local area.

PATIENTS WITH INSURANCE: The PATIENT/GUARUANTOR is responsible for the ESTIMATED non-covered portion, procedures and/or deductibles at the time of service. We are more than happy to file your insurance claim for you. Please keep in mind that the estimated portion is just that, an estimate. Filing insurance claims is a courtesy that we extend to our patients. We make every effort to follow up on unpaid insurance claims, however if we have not received payment after 60 days we ask you to discuss your claim with your insurance company. If insurance pays less than the estimated portion, patients are responsible for the balance.

NON-INSURED PATIENTS: If you do not have dental insurance, we ask for payment in full at the time of service. If you feel that financial arrangements are necessary, you may discuss this with the front office staff before treatment is started.

BALANCES: Are due within 30 days from the initial statement date. Any balance not paid within 90 days will be forwarded to a collection agency and will affect credit score.
There is a $300 processing charge for non-sufficient funds or returned checks.

PARENTS NOT ACCOMPANYING THEIR ADULT CHILD to an appointment must make PRIOR arrangements for payment (cash, check or credit card authorization). A parent or legal guardian must be present for an appointment for a minor. DIVORCES
Both partners are responsible for the debts incurred up to the date of the divorce decree. The parent who requests treatment for a child is responsible for the balance of services rendered for your child.


NO-SHOW AND CANCELLATION POLICY: Your visit has been reserved for you and instruments, chairs, and personnel are reserved exclusively for your appointment. If you are unable to keep your appointment we require 48 BUSINESS hours notice for cancellation/re-scheduling. If 48 BUSINESS hours notice is not provided a late cancellation fee of $50 will be applied to your account for missed consultation and $200 will be applied for missed surgical appointment.


PARENTS ACCOMPANYING THEIR CHILDREN are considered financially responsible for payment, unless any other arrangement is made prior to the appointment.

EMERGENCIES: Should you experience a dental emergency during non-business hours, please call our office. The recorded phone message will provide an emergency contact number.

Records can be viewed at any time. There is a nominal charge for release or copies of records.