Financial /REscheduling/Cancellation Policy
At MOUNT VERNON PERIODONTICS AND IMPLANTS, we feel strongly that our patients deserve the best care. In an effort to provide high quality care, we would like to share information with you about financing healthcare. We hope that by providing you with the following information, we can prevent misunderstandings and that you will be comfortable discussing financial and insurance matters with us. We thank you for your understanding and cooperation.
Private Pay: If insurance is not to be billed, then you are responsible for all costs of services rendered. We ask that you pay in full on the day of service.
Patients with Insurance: If you have insurance, please pay that portion which insurance does not cover. For your convenience, payments may be made with cash, personal check, and bank draft, Visa, or MasterCard. We also take Care Credit. You can apply for Care Credit here.
Remember that, if you have insurance, the insurance contract is between the patient and the insurance company. The patient is responsible for all account balances, even with insurance benefits. We will only bill those insurance companies for which you provide information to us prior to the treatment given. If your insurance provider informs us of dental benefits that you are entitled to, we will advise you of it. Any oral representation we make in good faith to you concerning your insurance is not binding on us and will not in any way or for any reason be considered a modification of this writing.
In the end, however, you are responsible for your account with us, regardless of whether you have dental insurance or not. Therefore, if we have not received payment from your insurance within 90 days of submitting the initial claim, then we will ask you to pay the balance in full.
This information sheet is the full and final agreement between this office and you regarding your insurance and benefits and may not be modified without a written agreement signed by you and this office.
Many insurance plans cover a certain percentage of the fees. Normally, the insurance company will cover the “usual and customary fees.” These benefits are determined normally by how much your employer paid for the plan. Your insurance, as a result, may cover less than you thought they might have. Please be familiar with the benefits provided by your plan.
The age majority in our state is 18 years old. The parent that brings in the minor child is responsible for payment for the services provided.
Past due accounts will be sent to a collection agency at our discretion. We charge $35 for checks returned for any reason. We use Physicians & Dentists Credit Bureau as our collection agency.
Your appointment is reserved for you only. We do not double book. Please understand that if you need to reschedule an appointment, or cannot make an appointment, we ask you kindly give us 48 hours’ notice to avoid cancellation/ no show fee. If you do not give adequate notice, your account will be charged a $50 cancellation fee for missed hygiene appointments and a $100.00 cancellation fee for missed surgery appointments. Please be aware that Friday is not a normal day of business for our office.
If you cancel more than 2 consecutive appointments without appropriate notice, your active patient status will be reduced to emergency status, and you will be advised to seek an alternate dental provider.
If you have any questions or concerns, please ask our staff. They are very well informed and up-to-date. They can be reached by phone at Mount Vernon Periodontics & Implants Phone Number 360-424-5175 or by fax at 360-424-5177. Our office location is 120 East Fir Street Suite 101.