Thank you for choosing Pediatric Dental Partners as your child’s dental care provider. We are committed to your treatment being successful. Please understand that payment of your bill is considered a part of your treatment. The following is a statement of our Financial Policy, which we require you to read, and sign prior to any treatment.
PAYMENT IS DUE AT THE TIME OF SERVICE
WE ACCEPT CASH, CHECKS, OR VISA/MASTER CARD/ DISCOVER
AND CARE CREDIT
REGARDING INSURANCE
We require your portion of services to be paid at the time of service. The balance is your responsibility whether your insurance company pays or not. We cannon file with your insurance company unless you give us your insurance information. Your insurance policy is a contract between you and your insurance company. We are not a party to the contract. In the event that your insurance coverage changes, please bring your new insurance card to the first visit following the change. If your insurance company has not paid your account in full within 45 days the balance will be due by you.
Since we are not a preferred provider with any insurance company, we do not accept co-pays for HPO, HMO, or PPO.
TIME OF SERVICE
The parent, adult or guardian accompanying the child is responsible for full payment. For unaccompanied minors, non-emergency treatment will be denied unless charges have been pre-authorized to an approved credit play (Visa, MasterCard, Discover) or payment by cash or check at the time of service has been verified.
CANCELLATION AND NO-SHOW POLICY
We require 48 hours notice for any appointment changes.
INTEREST
We reserve the right to charge interest and collect any fees incurred by us to your account when it is not paid in full.