OFFICE FINANCIAL POLICY
ATTLEBORO PERIODONTICS AND IMPLANTOLOGY
Practice Limited to Periodontics and Dental Implants
Sheldon J. Itzkowitz, DDS, FICD
OFFICE FINANCIAL POLICY
We are committed to providing you with the best possible treatment. Our fees reflect our professional commitment to excellence. If you have dental insurance, we are happy to help you receive your maximum allowable benefit. In order to achieve these goals, we need your assistance and understanding of our payment policy.
All services performed are to be paid in full at the time of treatment. Patients with insurance will pay their co-payments in full on the date of service, no exceptions.
We will gladly help any patient with their insurance reimbursement by submitting all claims to their insurance company. It is important you realize that your dental benefit program is a contract between you, your employer and the insurance company. We are not a party to that contract. It is your responsibility to be aware of your insurance plan coverage, eligibility and deductibles, co-insurance, and benefits provisions.
Our office accepts Mastercard, Visa and Discover, which allows you the time for the processing of your insurance reimbursement. Patients without insurance or not using insurance for the visit must pay their bill in full at the time of service.
We offer a 6 month no interest payment plan through Citi Health Card. For more information, visit , or speak with one of our front desk staff.
As a courtesy, we call all of our patients 2-4 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.
Appointments cancelled without 24 hours notice are charged $80.00 for the dental hygienist and $200.00 for the dentist.
Thank you for taking the time to read this policy. Please sign below indicating that you have read, fully understand and agree to our office financial policy.
Signature_________________________
Date______________________________
288 Highland Avenue, South Attleboro, MA 02703
Phone (508) 761-5007 Fax (508) 761-7840
attleperio@
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related searches
- nonprofit financial policy manual
- financial policy pdf
- sample financial policy for nonprofits
- financial policy template
- financial policy template for nonprofit
- don financial policy manual
- financial policy and procedure pdf
- financial policy and procedure
- financial policy for company
- financial policy sample
- office of financial policy va
- financial policy for nonprofit organization