In an effort to maintain treatment fees at a minimum while maintaining a high level of professional care, we have established the following financial policy for our office. Please feel free to discuss our fees with us at any time. Before any dental treatment has begun, the patient and/or responsible party will receive a consultation regarding treatment plan and cost.
We require payment in full for the portion, not covered by dental insurance, of dental services to be rendered. For procedures that take multiple appointments to complete, payment may be split up over the number of appointments required, payments for prosthesis are required to be made by final appointment for prosthesis to be delievered. We accept Cash, American Express, Visa, MasterCard, Discover, and outside financing through Care Credit. Outside financing credit applications to help assist with the cost of your dental treatment are available upon request. Personal checks are not accepted at Mint Dentistry.
By signing below the Patient/responsible party agrees, there is an understood “Assignment of Benefits” to Mint Dentistry (and affiliated companies). In some instances, the assignment of benefits is sometimes mistakenly overlooked by insurance companies and mailed to patients; and in that scenario the patient is responsible for signing the check over to Mint Dentistry. The balance will be the patient’s responsibility.
As a courtesy to our patients with insurance, we will file your insurance claim, allowing you to pay only your deductible and/or estimated co-payment as services are rendered. Please remember that the contract is between you and your insurance company. We make every effort to give you an accurate estimate of what your portion of our fees will be, based on the information provided to us. However, we have no way to guarantee the actual terms of your policy. Any dispute coverage or the amount of reimbursement is between you and your insurance carrier. By agreeing to this policy you agree to all such terms and conditions.
At Mint Dentistry we schedule our appointments to provide each patient with our undivided attention. In order to accomplish this, we require a 24 hour confirmation on all appointments. Please be advised that you will be charged for cancellations with less than 24 hours’ notice at the rate of $50.00 for examination/hygiene appointments and $75.00 for dental procedures appointments. Also note that payment for services that are provided by patients for Mint Dentistry will be applied to patient balances. Should the patient change their mind for whatever reason during treatment, patient will still be responsible for full payment. Mint Dentistry guarantees cosmetic crowns and posterior crowns from breaking with a replacement crown as long as the patient returns every six months for their checkup and cleaning. We appreciate your confidence in choosing our practice. Please do not hesitate to inquire with a staff member should you have any questions regarding this policy.
I have read, understood and agree to the Office Financial Policy stated above.