551 Boylston street suite 501, Boston, Ma 02116



FINANCIAL & INSURANCE INFORMATION


Financial Policy Summary
We are committed to providing you with the best possible treatment. Our fees reflect our professional commitment to excellence. However, in order to keep the cost of dental treatment to a minimal, we are implementing this financial policy effective January 1, 2006. If you have dental insurance, we are happy to help you receive the maximum allowable benefits. In order to achieve these goals, we need your assistance and understanding or our payment policy.


Unless prior arrangements are made, all services performed are to be paid in full at the time of treatment. The only exception is for those patients covered by Delta Dental and BCBS. Delta Dental and BCBS patients will pay their co-payment in full on the date of the service.

We have implemented two payment options that are available to all our patients. Option #1 requires patients to pay in full at the time of performance for all services performed. Under this method, the patient is responsible for submitting all claims to their insurance company. The reimbursement checks in this case will be sent directly to the patient. It is important to realize that the dental benefit program under this option is a contract between you, your employer, and the insurance company. We are not a party to that contract. Option #2 allows for us to submit all claims to the insurance company on behalf of the patient.  Under this method, the reimbursement checks will be mailed directly to our office. The patient is however responsible for the co-payment at the time of service and all non-covered services.

For your convenience, our office accepts different method of payments including all major credit cards. In order to allow timely processing of payments, we REQUIRE that all patients leave a valid credit card on file. In the event of delinquent balances, we will notify you and automatically transfer any unpaid balances.

As a courtesy, we call all our patients, as a reminder, 1-2 days prior to their scheduled appointments. We appreciate you providing us with two phone numbers to assure confirmation. If you are unavailable, we will leave a message asking you to return our call.

Please take time and carefully read the terms and conditions of our new policy. We will gladly answer any questions you may have. Thank you for taking the time to read this policy. Please sign below indicating that you have read all pages of the agreement and fully understand and agree to our office Financial Policy.

For your convenience, our office accepts different method of payments including all major credit cards. In order to allow timely processing of payments, we REQUIRE that all patients leave a valid credit card on file. In the event of delinquent balances, we will notify you and automatically transfer any unpaid balances.

As a courtesy, we call all our patients, as a reminder, 1-2 days prior to their scheduled appointments. We appreciate you providing us with two phone numbers to assure confirmation. If you are unavailable, we will leave a message asking you to return our call.

Please take time and carefully read the terms and conditions of our new policy. We will gladly answer any questions you may have. Thank you for taking the time to read this policy. Please sign below indicating that you have read all pages of the agreement and fully understand and agree to our office Financial Policy.



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