dental office financial policy template

We are committed to providing you with the highest quality lifetime dental care so that you may attain optimum oral health. Payment for services rendered is due in full on the day of service.


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Office Policies and Financial Agreement.

. SAMPLE DENTAL OFFICE EMPLOYEE MANUAL Revised. Everyone benefits when office and financial policy arrangements are understood. We are committed to providing you with the best possible care.

At Oral and Maxillofacial Surgery Associates of WNY we make every effort to provide you with the finest surgical care and the most convenient financial options. Our office is committed to providing you with the best possible care. Do you have a transparent patient payment agreement signed by each of your patients.

If you have any questions regarding. We are committed to your treatment being successful. Heres the form for you.

In order to achieve this we need your. The office has a 48-hour cancellation policy. Financial Policies - Aspen Dental.

Please understand that payment of your bill is considered part of your treatment. To accomplish this goal we work hand-in-hand with you to maximize your insurance reimbursement for covered procedures. Oneida Dental Group 308 Main Street Oneida New York 13421 315 363-4850 OFFICE FINANCIAL POLICY YOUR DENTAL BENEFITS We would like our patients to be informed of our financial policy.

INDICATE THAT YOU HAVE READ AND UNDERSTAND OUR OFFICE FINANCIAL POLICIES TO THE BEST OF YOUR ABILITY. Calgary AB T2Y 3Y4. Payment plans and financial arrangements are available for comprehensive dental treatment.

We believe in the importance of patient education and ensure that you are thoroughly informed by taking the time necessary to listen to your individual concerns and desires. With the highest quality lifetime dental care so that you may fully attain optimum oral health. All patients will be asked to complete and sign a Payment Options form instructing our office which method of payment they prefer.

Please understand that payment of your bill is considered part of your treatment. Its template format provides a straightforward easy-to-understand approach that can streamline the process of developing key policies and procedures. The following is a statement of our Financial Agreement.

Financial Policy for all patients Thank you for choosing us as your dental care provider. This form explains to all of our patients the billing process only of the office -- much like a payment agreement for a credit card or billing policies and procedures for utility companies. Our office accepts cash and credit cards.

Patient Treatment and Financial Policy Thank you for choosing our office as your dental healthcare provider. Our primary goal is not to allow the cost of treatment to prevent you from benefiting from the quality care you need or desire. For the answers to any other questions you have please refer to our Dental Office Information and Policies brochure available at the office and or.

This is an insurance company policy. The parent who brings the child in to the dental appointment is responsible for paying the co-payment or full fee. Please note that we do not offer free consultation in this office.

The following is our Financial Policy. If you have any problems or questions. Everyone benefits when office and financial policy arrangements are understood.

Patient payment agreement form. In order that we may have a definite understanding in regard to the payment for dental services the. Please understand that payment of your bill is considered as part of your treatment.

Our main concern is that you receive the proper and optimal treatment needed to restore and maintain your dental health. Your understanding of our financial policy is an essential element of your care and service. The following describes our Financial Policy.

However the IMPORTANT NOTICE that appears on page 1 and again under the heading ATTESTATION BY EMPLOYEE on page 14 should not be altered or reduced in font size. It is our desire to provide the highest quality dental care to everyone. Are you tired of chasing co-pays.

Dental Insurance In order for us to maintain a high level of service to you we provide the courtesy of submitting your insurance claim on your behalf and supporting you with maximizing your benets. Therefore if you have any questions or concerns about our payment policies please do not hesitate to contact our office staff. We accept checks Visa MasterCard American Express Discover and Care Credit but we cannot take cash.

Office Policies Mission. At Wood Dental our top priority is taking care of you. January 2019 This is a sample manual.

Office policies and Financial Agreement. Procedures may be covered by dental andor medical insurances depending on your coverage. Wood and his skilled team specialize in.

DENTAL OFFICE FINANCIAL AGREEMENT Thank you for choosing us as your dental care provider. Abenaa Ayeh 2 17107 James McKevitt Rd SW. The following is a statement of our financial policy which we require that you read and sign prior to any treatment.

All office co-payments are to be paid at the time of service. If it is necessary we are happy to hold a creditdebit number from the non custodial parent on file. Additions deletions or changes should be made to reflect the policies and practices in your office.

Are you providing transparency in your dental practice. Our fees are based on the quality materials we use and the time effort and skill. The following is a statement of Dr.

The following is a statement of our Financial Policy which we require that you read agree to and sign prior. We also accept personal checks with valid state ID up to 1500. In our office we strive to maximize your insurance benefits and make any remaining balance easily affordable.

Therefore we strive for excellence each day. We ask that all patients read and sign our financial policy. Insurances vary in their coverage and it is the patients responsibility to understand hisher dental benefits.

Patients who cancel or miss an appointment without 48 hours notice will be asked to make a deposit of 50 of their co-pay or 45 whichever is greater to re-schedule their appointment. This valuable ADA resource comes complete with nearly 100 sample dental office policies as well as definitions of key HR terms and even samples of dental job applications. The highest quality dental care so that you may fully attain optimum oral health.


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