Financial & Insurance

patient

OUR FINANCIAL POLICY

Thank you for choosing us as your health care provider. We are committed to your treatment being successful. Please understand that payment of your bill is considered part of your treatment. The following is our office policy.

Full payment is due at the time of service
We accept:
CASH – CHECK – VISA – MASTERCARD – DISCOVER – AMEX
All treatment must be paid in full at time services are rendered.

All treatment plan fees are valid for 90 days after receipt.

REGARDING INSURANCE – We may accept assignment of insurance benefits when your actual treatment begins. Examinations, consultations, maintenance visits, and surgical appointments are to be paid for at the time of the visit, and insurance will be filed for your direct reimbursement. In order to file your insurance for you, we require a completed, signed form and all other pertinent information (policy number, social security number, etc.). Please note, we DO NOT submit to medical insurance carriers. Furthermore, we have opted out of the Medicare program and claims CANNOT be submitted by our office or yourself. Please inquire for additional information.

We will submit a pre-treatment estimate to determine your coverage for your treatment upon request.

Your insurance policy is a contract between you and your insurance company.
WE ARE NOT PARTY TO THAT CONTRACT

Cigna PPO (with exception to Baycare)
Cigna Savings Plan
GEHA PPO
Aetna PPO
Aetna Dental Access
United Concordia PPO (with exception to Tricare Dental Program)
Principal PPO
Ameritas PPO
Reliance PPO
Physician’s Mutual PPO
Highmark Companies PPO
First Priority Life PPO
First Priority Health PPO
SunLife Financial PPO
Assurant PPO

UCR (Usual and Customary Rate) – Our practice is committed to providing the best treatment possible and we charge what is reasonable and customary in our area. You are responsible for payment in full regardless of any insurance company’s arbitrary determination of usual and customary rates.

MINOR PATIENTS – The parent accompanying a minor patient is responsible for the payment of the account.

MISSED APPOINTMENTS – Unless cancelled at least 24 hours in advance, our policy is to charge a fee of one half of that missed appointment. We require 5 business days notice to reschedule or cancel surgical appointments without incurring a fee, and charge half of the surgical fee if notified less than 5 business days. Please help us to serve you better by keeping scheduled appointments.

DEPOSIT POLICY

The following policies have been designed to maintain an efficient surgery schedule and ensure the fair distribution of the doctor’s surgery time for all of his patients. We hope the policies do not cause significant inconveniences and truly appreciate your cooperation.

  • How much? A non-refundable deposit of $100 in cash, check, or credit card (Visa, MasterCard, Discover, or American Express) is required to reserve your desired surgical date, and is due at the time of reserving the date of your surgery.
  • When to reserve space? You are welcome to make your reservation for surgery on the day of your consultation. If you later realize that work or other scheduling conflicts exist, your deposit will be fully credited toward a more convenient surgery date so long as five business days’ notice is given.
  • Rescheduling. In order to receive full credit for your deposit, please notify our office at least five business days prior to your scheduled procedure date. We understand that personal situations can arise unexpectedly and you may reschedule your surgery as often as necessary without penalty provided we receive five business days advance notice.
  • Final Payment. Final payments must be received at the time of the surgical appointment. We accept cash, money order, bank check, or credit card.

Thank you for placing your trust in Michaud Periodontics & Dental Implants.