• Insurance


    We are pleased that you have insurance benefits to help with the cost of your orofacial care. We would like to help you obtain the maximum use of these benefits. With this in mind, please read the information on our insurance claims process so that we can work together to maximize this benefit.


    DO YOU ACCEPT MY INSURANCE? HOW MUCH WILL THEY PAY?
    We will provide you a walkout statement called a “superbill” that itemizes your treatment for insurance reimbursement. When YOU submit this superbill, the insurance company should reimburse you directly. Please check with your insurance company prior to your appointment to see if you will be reimbursed.


    INSURANCE DIDN’T PAY, NOW WHAT?
    We provide you with a “superbill” as a courtesy. It is YOUR responsibility to collect the insurance funds that are due to you. The insurance you have is a legal contract between YOU and your insurance company. Our office is not, and cannot be, a part of that legal contract. Ultimately, you are responsible for all charges incurred in our office.


    FINANCIAL OPTIONS
    Payment for treatment rendered is due at the time of service. We accept MasterCard, VISA and CareCredit. If you are in need of an extended finance option, your local credit union may offer payment options. These are all designed to meet your treatment plan needs.


    We welcome you and look forward to helping you achieve your wellness goals. If there is anything we can do to make your visits here more pleasant, please don’t hesitate to ask one of our staff members.


  • Financial Policy


    We appreciate the trust you have placed in us by choosing our dental practice. In order to make your experience smooth and pleasant, we ask that you read and acknowledge our financial policy.

  • If you have insurance…
    As a courtesy, we will provide you a “superbill” at the conclusion of your treatment. You may submit this form directly to your insurance provider. Any payments from the insurance company will be sent directly to you. Dr. Azouz is not a preferred provider for ANY insurance company. You may find that our fees may be different from the insurance company's schedule of "allowable" or "UCR" fees. If you have questions about "UCR" fees, please feel free to ask. All services rendered are charged directly to the patient, and the patient is ultimately responsible for the account regardless of insurance coverage. If a claim is denied, or if the insurance does not pay what you thought they would pay, it is YOUR responsibility to file an appeal.


    In the event that my account is not paid as agreed, and must be turned over to a collection agency for settlement:

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  • (Your digital signature (full name) is as legally binding as a physical signature.)

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