It is important for you to understand that the contract regarding your dental benefits is among you, your employer, and your insurance company. Your obligation to our practice is to pay for the treatment, regardless of the amount that may or may not be reimbursed by your insurance company.

Our office will accept payment directly from your insurance company with the following provisions.

Although we are willing to complete insurance forms and submit claims on your behalf, we do not accept responsibility for the outcome of the transaction. Completing insurance forms is a courtesy we extend to you in an effort to maximize your insurance reimbursement. It is important that you understand that this does not eliminate your financial obligation to us for your treatment.

If applicable, you will be required to sign document(s) authorizing your insurance company to make payments directly to our office.

Our office makes no guarantee that your insurance company will pay for any treatment you receive from this practice, or what amount it may pay. We perform routine insurance billing procedures upon verification of your coverage. However, if your claim is denied, or paid at a lesser amount than anticipated, you will be responsible for paying the full balance at that time.

Our office will not enter into a dispute with your insurance company over any claim, although we will provide any necessary documentation you or your insurance company requests to sort out any questions or confusions that may arise. We will cooperate fully with the regulations and requests of your insurance company.

It is ultimately your responsibility to resolve any type of dispute over payments made or not made by your insurance company.