Thank you for choosing our office as your dental healthcare provider. We are committed to providing you with the highest quality lifetime dental care, so that you may attain optimum oral health. The following is a statement of our financial policy, which we require that you read, agree to, and sign prior to any treatment. Payment is due at the time service is provided. Our office accepts cash, personal checks, credit cards and outside patient financing.
DENTAL BENEFIT PLANS
As your dental care provider, our relationship is with you, our patient, not with your insurance company. Your insurance policy is a contract between you and your insurance company; it is up to the patient to fully understand their dental benefit policy, frequency limitations, and so forth.
- As a courtesy to you, we will process your insurance claims after services are rendered.
- We make no guarantee of coverage by the dental benefit plan. We calculate coverage and copays to the best of our ability, but these suggested fees are estimates and may be inaccurate.
- As a courtesy, we submit treatment plans to insurance companies for pre-authorization in order for the patient to best know their coverage. These pre-preauthorizations are often sent to the patient by the insurance company within 30 days of submission, but may not be. It is up to the patient to contact their insurance company to request the pre-estimate.
- If an insurance company has not made payment within 30 days, we ask that you contact your insurance company for updates.
- Patients are responsible for paying the full amount of services rendered. Where insurance denies benefits, frequency limitations are met, and so forth, the full balance remains the patient’s responsibility.
- Payment of copay and deductibles are due on the date of service. Lexington Smile Design Studio does not provide loans or credit, and therefore charges a fee for unpaid account balances. The outstanding balance will be charged a 5% simple interest fee every 30 days it remains on the account.
- We will cooperate, within reason, in the requests of insurance companies that assist in the claim being paid. Our office will not, however, enter into a legal or prolonged dispute with your insurance company over any claim.
BROKEN AND MISSED APPOINTMENTS
We reserve the right to charge for missed appointments (no show) or appointments canceled (broken) within 24 hours of the appointment time. Monday appointments must be canceled by the close of business on the prior Thursday to avoid being subject to the fee. Please call as early as possible to reschedule the appointment. If a patient has two or more broken appointments in a six month period, the patient will be placed on our “on call” list and may only schedule same day appointments or the patient will need to pay the full service fee in order to schedule ahead of time.
- Missed Appointment: An appointment is considered missed (no show) once a patient is 10 minutes late for the scheduled time and has not contacted the office or responded to attempts by the office to contact the patient.
- Late Arrival: Late arrivals may not be served in full. If a patient arrives more than 10 minutes late, the appointment may have to be rescheduled.
- Dental Appointments: The fee for missing or canceling an appointment with less than 24 hour notice will be 20% of the scheduled procedure fee.
- Hygiene Appointments: The fee for missing or canceling an appointment with less than 24 hour notice is $85 for a routine cleaning appointment. The fee for periodontal hygiene appointments (SRP, etc.) is 20% of the scheduled procedure fee.
CareCredit®
Lexington Smile Design Studio is a provider through CareCredit. CareCredit offers the flexibility of making low monthly payments over time in exchange for an added 10% administration fee.
PAST DUE ACCOUNTS
When an account is over 90 days past due, it may be turned over to a collection agency, primarily where the patient is unable to be contacted and has not made effort to pay down the owed balance. Once the balance is paid, payment will be due in full the day of the service for all future appointments. Dental claims will still be filed for the patient, with the dental insurance paying out to the patient instead of the office.
When a patient account is sent to collections, the patient may only schedule same day appointments, and must pay in full prior to services rendered.
LIST OF FEES
- For your convenience, please review the fees outlined in this document:
- Dental Appointments: The fee for missing or canceling an appointment with less than 24 hour notice will be 20% of the scheduled procedure fee.
- Hygiene Appointments: The fee for missing or canceling an appointment with less than 24 hour notice is $110. The fee for periodontal hygiene appointments (SRP, etc.) is 20% of the scheduled procedure fee.
- Returned Checks: A $50 fee will be charged for each returned check. Patients with returned checks may only pay by cash, credit card or certified funds thereafter.
- Outstanding Account Balances: Outstanding account balances will be charged a 5% simple interest fee every 30 days it remains on the account.
- CareCredit: CareCredit offers the flexibility of making low monthly payments over time in exchange for an added 10% administration fee.
- Legal Fees: In the case it becomes necessary for our office to enlist a collection service and/or legal assistance, the patient will be responsible for any collection and/or legal charges up to 35%.
If you have any questions about our financial policy or to schedule an appointment with our Dr. T. Max Frawley, our dentist in Lexington, South Carolina, contact our team today at 803-359-7100.
