Common Contracts
1 similar Financial Policy and Agreement contracts
Financial Policy and Agreement and Cancellation PolicyFinancial Policy and Agreement • December 9th, 2024
The goal of TOTEM LAKE FAMILY DENTISTRY is to provide exceptional customer service and excellent dental care with both a professional and warm, personal touch. We want to make certain that our financial policies are clear and understood by you. If you have insurance, we will make a good faith estimate of your benefits and defer billing to you for that amount up to 60 days. We will file the appropriate claim forms with your insurance company, provided that you provide us with your personal information including social security number, ID number and date of birth. We will also assist you in understanding your dental plan benefits. If your insurer denies coverage, or if we otherwise do not receive payment within 60 days from the date services are rendered, the amount will then become due and payable by you. Please remember that your coverage is a contract between you and your insurer and/or your employer and your insurer. Although we will make every effort to help you obtain your benefits
