All professional services rendered are charged directly to you and you are responsible to pay fees directly to our office. Payment for services is due at the time the service is rendered. All appliances, dentures, crowns, etc., must be paid for at the time they are delivered, or in compliance with special payment arrangements.
We strongly recommend you contact your insurance company to ask about deductible, coinsurance, benefit coverage, year-to-date benefits remaining, etc. We will prepare the necessary forms or reports to help you obtain benefits from insurance companies, upon receipt of full (or partial) payment of bill. We do not render our services on the basis that insurance companies will pay all our fees. Each fee is individual for the individual patient.
Late Charge Policy
In the event payment is not made at the time service is rendered, a monthly statement will be sent. You will avoid a late charge if we receive your payment within 10 days. With all accounts where payment is not received within 10 days of the date the statement is received, a finance charge of 1.5% per month will be charged on the outstanding balance. In the event it becomes necessary to file a legal action or proceeding to collect the account, the responsible party agrees to pay in addition to any amounts due and owing, reasonable attorney’s fees and court costs.
Keeping Your Costs Down
Our office policy is to have each patient sign a statement similar to this prior to receiving services. We have found this is the most efficient way to offer you the best value and service for your dental care. This policy helps keeps our overall costs down by reducing resources spent on billing. We so much appreciate your understanding.
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