At Kenmore Dental our primary mission is to deliver the best and most comprehensive dental care available. An important part of our mission is making the cost of optimal care as manageable for our patients as possible by offering several payment options. Specific financial arrangements will be made at the time the treatment is scheduled. Our general financial practices and patient agreement and consent are:
- For patients with dental insurance, the uninsured portion is due at the time of treatment. We will be happy to bill your insurance for you and bill your credit card (Visa, MasterCard, American
Express, and Discover) for the uninsured portion of your bill.
- For uninsured patients, all fees are due at the time of treatment. You may use cash, debit, or credit card. (Visa, MasterCard, American Express, Discover).
- For those who need extended payment arrangements, we offer CareCredit, a finance plan that offers interest-free loans for up to 12 months and low interest loans up to 60 months on approval of credit.
- Unpaid balances after 90 days will be assessed a finance charge each month past due.
- I hearby authorize payment directly Priya Sridhar, DMD and/or Kenmore Dental for the dental benefits otherwise payable to me.
- Priya Sridhar, DMD and Kenmore Dental are authorized to provide any insurance company(s), claim administrator(s) and or consulting health professionals, information concerning advice, treatment, diagnostic images taken, or supplies provided. This information will be used for the purpose of evaluation and administering claim benefits.
- Appointments cancelled with less than a two day notice or appointments not kept will be subject to a $75.00 fee.
Regardless of any insurance that I may have, I understand that I am fully responsible for the full amount of fees and the financial arrangements agreed to relating to my care and treatment, and the care and treatment of family members as applicable.