Common Contracts
1 similar Financial and Appointment Policies and Agreement contracts
Financial and Appointment Policies and AgreementFinancial and Appointment Policies and Agreement • April 6th, 2015
As a courtesy to our patients and their families, we will gladly file the forms necessary to see that you receive the maximum benefits of your dental coverage and we will wait on payment from your insurance company. However, no dental insurance pays 100% of all charges. If your insurance company denies coverage, or we otherwise do not receive payment within 30 days of filing your claim, the amount will then become due and payable by you. Our practice management software tries to estimate your portion of the dental bill at each visit, but remember that your coverage is a contract between you and your insurance company and/or your employer and your insurance company. Although we make a good faith effort to assist you in obtaining your benefits, we cannot force your insurance company to pay. Regardless of the estimated insurance coverage, any fees incurred for services received will be your financial responsibility.
