Common Contracts
2 similar Policy and Agreement contracts
LEGACY DENTAL GROUP FINANCIAL POLICY AND AGREEMENTPolicy and Agreement • January 20th, 2014
We realize that every person’s financial situation is different. For this reason we have worked hard to provide a variety of payment options to help you receive the dental care needed to enjoy a healthy and confident smile while respecting to your budget. With regards to dental insurance or benefits, we are happy to file the forms necessary to see that you receive the full benefits of your coverage; however we can make no guarantee of any estimated coverage. Because the insurance policy is an agreement between you and the insurance company, we ask that all patients be directly responsible for all charges. Please know that we will do everything possible to see that you receive the full benefits of your policy. If for some reason your insurance company has not paid the estimated portion within 30 days from the date of treatment, you are responsible for payment at that time. Please present your insurance card at each visit. To better serve you, all insurance information must be provided a
LEGACY DENTAL GROUP FINANCIAL POLICY AND AGREEMENTPolicy and Agreement • July 1st, 2009
We realize that every person’s financial situation is different. For this reason we have worked hard to provide a variety of payment options to help you receive the dental care needed to enjoy a healthy and confident smile while respecting to your budget. With regards to dental insurance or benefits, we are happy to file the forms necessary to see that you receive the full benefits of your coverage; however we can make no guarantee of any estimated coverage. Because the insurance policy is an agreement between you and the insurance company, we ask that all patients be directly responsible for all charges. Please know that we will do everything possible to see that you receive the full benefits of your policy. If for some reason your insurance company has not paid the estimated portion within 30 days from the date of treatment, you are responsible for payment at that time. Please present your insurance card at each visit. To better serve you, all insurance information must be provided a
