DSP Membership Savings Plan Exclusions and Limitations

• Membership fees are due, in full, at time of service and are not refundable when any treatment provided equals or exceeds the costs of the membership fee.
  
  
• Membership fees must be paid prior to any treatment to receive discount on those services.
  
  
• All payment for services, are due in full at time of services in order to receive DSP savings.
  
  
• DSP is offered to patients without dental insurance and to those without PPO based insurance program (s)(please ask if you are unsure if you are on a PPO based carrier)
  
  
• DSP Participants cannot use insurance benefits or any other dental coverage in conjunction with their Dental Savings Plan membership
  
  
• Interest-free payment plans of 6 or 12 months in duration may be available upon request with approved credit. Repayment duration is based on service totals and procedural type. If you choose to use a repayment plan (ie: Care Credit, Sunbit), your DSP Member Savings and interest free payment options will be customized for your repayment needs. For example, third party payment costs are 10% so your DSP discount will be 5%.
  
  
• Unused services, part of the DSP membership program, are not transferrable to other patients, to other offices and do not roll over to the next membership year.
  
  
• A 48-hour notice is required to reschedule and/or cancel appointments or we reserve the option to bill you 25% of the scheduled treatment amount for your missed appointment.
  
  
• If you have Periodontal Disease, a Periodontal Maintenance will be performed, as a ‘simple’ cleaning will not be sufficient for your oral health care needs. The simple cleaning benefit, included in the DSP membership, will be applied to the costs of your Periodontal Maintenance cleanings two times in your plan year. The difference in cleaning fees will be your responsibility at the time of service. Each additional recall, we will offer you a 15% savings on your periodontal maintenance cleanings when you pay for them in full at time of service.
  
  
• Restoration, splints or other appliances used to increase vertical dimension or restore occlusion.
  
  
• Treatment for sleep apnea.
  
  
• Services for injuries or conditions which are covered under Worker’s Compensation or Employer’s Liability laws.
  
  
• Services which are provided without cost to the member by any municipality, county or other political subdivision.
  
  
• Services that cannot be performed because of the general health, physical or psychological limitations of the patient.
  
  
• Periodontics, endodontics, oral surgery or pediatric dentistry, requiring the services of a nonparticipating dentist/specialist outside of our office.
  
  
• Those procedures requiring appliances or restorations that are necessary for full mouth rehabilitation, or to alter, restore or maintain occlusion, including, with limitation, treatment of disturbances of the temporomandibular joint.
  
  
• Demonstrated non-compliance with patient’s recommended course of treatment.
  
  
• Diagnosis and treatment of myofascial pain dysfunction syndrome.

• Treatment programs which began before becoming a DSP Participant.
  
  
• Lost or broken appliances.
  
  
• Additional fees may be charged by the dentist for a) gross and consistent non-cooperation and/or treatment non‐compliance by the patient, b) accidents occurring during the treatment, c) treatment plans involving surgical orthodontics, d) myofunctional therapy, e) temporomandibular joint treatment, f) loose, broken or lost bands/brackets.
  
  
• Treatment by any non‐DSP dentist or specialist.
  
  
• Orthodontic extractions.
  
  
• Referral out to a specialist to complete recommended courses of treatment in conjunction with orthodontic placement in our office.

*Dual plans consist of husband/wife, legal partners or parent/child.

**Child that is under 18 or students under 22 All members must reside in the same household.

Plan Details

• Plan will run for 12 months
  
  
• For Orthodontic patients, plan must be active to maintain discount
  
  
• For patients with gum disease, a deep cleaning may be indicated with additional preventative treatments 

By signing below, I acknowledge the above stated terms of Cambridge Dental Savings Plan.