Common Contracts
1 similar Dental Insurance Agreement contracts
Dental Insurance Information and AgreementDental Insurance Agreement • December 2nd, 2022
One of our office goals is to assist you in maximizing your dental insurance benefits. As a courtesy to you, we will file the claim to your dental insurance carrier for services rendered. Please note that we have contacted your provider to verify benefits and were told that verification of benefits is not a guarantee of payment by your insurance company. Exact amount paid may differ from the verification amount provided. Please remember that the contract itemizing your dental benefits is an agreement between you, your employer, and your insurance carrier.Regardless of coverage, your estimated copayment for services is due the day of treatment. We try our best to give you the most accurate financial estimate, however if other claims are filed by another dentist without our knowledge, your annual maximum benefit or frequency allowed for certain procedures may be reached prior to our claim being considered.Please initial
