James E. Pfost, DDS, PA
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OUR FINANCIAL POLICY We appreciate our patients and are thankful that they have chosen us as their dental care provider. We are committed to providing high quality dental care. Please understand that payment of your bill is considered part of your treatment. The following is a statement of our Financial Policy which we have designed to assist our patients in meeting this financial obligation: Full payment is due at the time of service. We Accept Cash, Checks, Visa, MasterCard, Discover, & American Express We Offer An Extended Payment Plan With Prior Credit Approval. If you would like additional information concerning these plans, please call our office (375-7786) or email us at jepfost@spro.net. We NOW accept CareCredit!! Need small monthly payments? Would like up to one year with no interest? Care Credit may be the answer for you. Go to the CareCredit website to apply today. Regarding Insurance We will accept assignment of insurance and we will be happy to bill your insurance as long as you provide the necessary information to do so. Your insurance policy is a contract between you and your insurance company. We are not a party to that contract and the fee for services is your responsibility whether your insurance company pays or not. If you are unable to pay your portion on the day of service, it will be necessary for you to be pre-approved on our extended payment plan. If you do have insurance, but we are unable to adequately estimate your benefits, it will be necessary for you to 1) pay the total in full 2) be pre-approved on our extended payment plan or 3) sign a credit card authorization to transfer any balance not paid by your insurance company to your credit card. If your insurance company has not paid your account in full within 45 days, the balance will automatically be transferred to your credit card or the extended payment plan. Please be aware that some, and perhaps all, of the services provided may be non-covered services and not considered reasonable and necessary under your dental insurance program. Usual and Customary Rates Our practice is committed to providing the best treatment for our patients and we charge what is usual and customary for our area. You are responsible for payment regardless of any insurance company's arbitrary determination of usual and customary rates. Minor Patients The adult accompanying a minor and the parents (or guardians of the minor) are responsible for full payment. For unaccompanied minors, payment is still due on the day of service. Broken Appointments Due to the number of broken appointments which have interrupted our ability to provide the prompt dental care which we strive for, there will be a $75.00 per hour "broken appointment fee" charged to all patients who do not notify us of their inability to make an appointment. (48 hours notice required.) No exceptions.
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