Payment FAQs

Payment Questions

Broken Appointment Policy

We understand that last minute changes in your schedule may be unavoidable and we will try to accommodate those changes as best we can. Please understand that when we make an appointment we are setting aside enough time to do our best work and that each appointment is for only one patient. We do not overbook expecting some of our patients to not show for their appointments. Therefore, a broken appointment without adequate notice results in wasted time for us, adding to the cost of providing care for all our patients.

To be fair, if you have an avoidable conflict and cannot give 24 hr notice to change the appointment, there will be no charge for the first time this happens. The second, subsequent cancellation for the same appointment will incur a fee of 1/3 the scheduled amount of treatment. A third subsequent cancellation of the same appointment will require prepayment of the entire fee prior to rescheduling and the fee forfeited if the appointment is not kept.

24-hour notice will give us time, usually, to fill in the appointment and there will be no broken appointment fee.

We will work with you to try to schedule times that are best for you. Patients who habitually reschedule for inadequate reason will be referred to an office which does not work by appointment or which can accommodate an unpredictable schedule.
Forms
Patient Info Form (PDF file)

Patient Privacy Form (PDF file)
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479-521-4822
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CareCredit

No Interest and Extended Patient Payment Plans

CareCredit is a revolving charge account that is easy to use, takes just minutes to apply and is ideal for all treatment costs not covered by insurance.

start treatment immediately
enjoy low monthly payments
finance up to 100% of the treatment cost
choose between several payment options
pay no upfront costs
pay no annual fees
complete the short application in just a few minutes
receive a response within seconds
use it for the whole family for ongoing treatment without reapplying
save your other credit cards for household or unplanned expenses.

Ask our receptionist for an application, apply via phone or online at: www.carecredit.com

We would be happy to work with you to plan out the most appropriate arrangements for your budget. Financing your treatment allows you to start your dental care immediately and spread out over a time period. Most importantly, it offers you the opportunity to enjoy the benefits of your dental health without the financial strain.

We want to thank you for trusting us as your health provider. We appreciate your trust in us and we appreciate the opportunity to serve you. Part of our service to you is to try to contain the ever-rising cost or health care. In an effort to do this, we have implemented a policy of no open billing. Our choices were between implementing this financial policy and increasing our fees more than necessary. In order to hold the line in costs and prices to you, we decided instead to implement this financial policy which will share the responsibility equally among all patients.

Payment Options

Our staff will work with you to determine the best possible payment options for you.

As a courtesy to our patients we file insurance claims electronically to expedite payment.

All fees of $200.00 or less must be paid at the time of the appointment. Payment may be in the form of cash, check, credit card, and may be combined with the estimated insurance payment. Pre-payment of treatment in full. Our office offers a 6% discount to those patients willing to pay for treatment in full (the entire treatment plan) in advance of treatment if paid with cash or check. A 4% discount is applied if paid by credit card. This requires that you file your own insurance and be willing to accept your own benefits.

Credit cards and Pre-authorized Credit Card Monthly Payments. Our office accepts Visa, Mastercard, American Express, and Discover. If you prefer to pay out larger potions of treatment on your credit card on a regular basis, we can accommodate you by having you sign monthly authorization card. Once per month tour card will be charged the allotted monthly amount. This helps you avoid large amounts of interest. A down payment will be required.

PAC. This is a separate line of credit extended by our office to cover over $300 not covered your insurance carrier. This is done through direct drafting of your checking account once per month. 1/3 down payment on your patient balance is required with the balance paid out up to 12 months and a minimum $50 per month.

Outside Dental Financing. Upon qualifying you will be extended a line of credit for treatment costs by an outside financing company. This financing is available for those patients who need to extend their payments over a longer period of time than six months. Payment will be made directly to the financing company. The qualification process is simple and can usually be completed within 20-30 minutes. Much of the payment period is interest free. For further information on this option please ask our financial coordinator.

Financial Policy For Our Patients

Our office wants all of our patients to be able to comfortably afford dental care. We proudly offer the following financial policy so that our patients can have the opportunity to decide which payment option best suits your needs.

Insurance: Our office understands the value of insurance benefits to our patients and will gladly work with you to help get the maximum benefit available to you. We will accept assignment of benefits. This means that you must sign the portion of the form that “assigns” payment to our office. We can file claims for any insurance that is not an HMO that requires you to see a specific dentist. Do not confuse a PPO with an HMO. With a PPO you should be able to see any dentist, but your co-payment may be slightly different from those on the insurance company’s list.

Most dental insurance plans do not cover 100% of the cost of your treatment. Because of this and the extreme delay in receiving payment from the insurance, you will be asked to pay your deductible and your portion of your charges the day the service is rendered. We will estimate as closely as possible your coverage, but until we actually receive the payment from the insurance company, it is just an estimate. We will assist you in dealing with your insurance company, but the ultimate responsibility lies with you. After 45 days the balance will be due in full from you. Our estimates are subject to final approval by your insurance company and could therefore change the amount due to or office. Secondary insurance must be filed by the patient. Payment of large amounts of co-payment or portions not covered by your insurance can be done according to the payment options below.

Non-Insurance: Payment for services are expected the day the services are rendered. After determination of the required treatment, we will work with you to sequence treatment and provide payment options that best suit you and that also allow us to provide the best possible care. Our payment options follow below.