Thank you for choosing Pickett Family Dental for your oral health needs. It is our goal to provide you with a positive experience. Over the past few years, the practice of dentistry has become more complicated for doctors and patients alike.
Because of the growing complexity of the insurance business, we feel that we can no longer assume that patients fully understand the relationship between the insurance company, the doctor, and themselves. In an effort to clarify this relationship, we have established a set of guidelines regarding financial responsibility and office policies.
We will file your insurance for you:
* As a service to our patients with insurance, we will bill your carrier on your behalf to maximize your benefits. Patient portions are estimated based on information supplied by your insurance carrier to us and are not guaranteed to be exact, therefore, any amount not covered by your insurance is your responsibility.
* It is your responsibility to understand your insurance plan coverage. If you do not understand your policy, you may wish to contact them to review and verify your benefits. Not all services are a covered benefit in all contracts. Some insurances arbitrarily select certain services or treatment codes which they will not cover. Our office never guarantees that your insurance will pay for all services. We will make every attempt to file your claim as straightforward and simple as possible. However, if for any reason your claim is denied, you are responsible for the amount due on your account.
* If we do not receive payment from your insurance carrier within 90 days, you will be responsible for payment of your treatment fees and collection of your benefits directly from your insurance carrier.
You can choose from:
* Cash, Check, Visa, MasterCard, American Express or Discover Card.
* There is a $20 charge for returned checks.
* We offer a courtesy accounting adjustment to patients who pay one week prior to treatment for treatment plans of $300 or more. If advanced payments are made by credit card, we offer a 2% savings, if by cash or check; we offer a 5% savings.
* NO INTEREST1 Payment Plans2 from Care Credit
- Allow you to pay over time with NO INTEREST1
- Convenient, low monthly payment plans2 also available
- No annual fees or pre-payment penalties
* Pickett Family Dental requires payment at time of service
* We will send you three statements regarding your balance. The second statement is considered past due. If you should receive a third statement noted “Final”, the account will be turned over to a collection agency. If are sent to a collections agency, a 35% collections fee will be added to your balance.
Missed appointments, Late Cancellations, & Non-Compliance
* Please keep in mind that appointments are time-slots reserved specifically for you. We require 48-hour advance notice if you are unable to keep your scheduled appointment. As a courtesy, we offer appointment reminder emails, text messages and calls which will allow you to cancel or reschedule at that time. However, it is ultimately your responsibility to keep track of your appointment whether you receive a reminder or not.
* If you miss an appointment without 48-hours advance notice or cancel/reschedule within the same time period, a fee of $75 per hour scheduled may be incurred on your account. This fee is not billable to your insurance.
* If you are more than 20 minutes late, your appointment may be cancelled, and you will need to reschedule. We encourage new patients to show up 15 minutes early to complete their registration.
* Patients with repeat cancellations or missed appointments may be discharged from our practice
* Abusive/inappropriate behavior towards staff or other patients may result in dismissal of your care from our practice.