Call us: (937) 746-9971
New Patient Info
New Patient Forms
Download and fill out a new patient form prior to your appointment. If you’d like to fill out your forms at your appointment, please arrive an additional 15 minutes prior to your scheduled visit to ensure you have enough time to complete them.
Financial Information
You are responsible for payment in full at the time of service, and for your benefit and convenience, we accept several forms of payment, Cash, MasterCard, Visa, and CareCredit.
As a courtesy to our patients, we will file dental claims to your insurance company if you provide us with the necessary information needed by your individual insurance company.
Please understand that your dental insurance is a contract between the insured’s employer and a dental insurance company. We understand that dental insurance coverage and benefits can be very complex and confusing. We will do our best to maximize your benefits to help your with the cost of your treatment.
As you are aware, dental insurance companies rarely cover 100% of dental fees and often cover less than 50% of the fee or nothing at all. With all dental insurance policies, you are expected personally pay for some percentage of very basic dental services, a copay and/ or for as much as 100% for many services. If your insurance company fails to cover any portion of your treatment, the responsibility for the cost of treatment is ultimately yours.
Any time you have a question about your dental insurance, please feel free to ask us. We will do all we can to answer your questions and help you understand the role of dental insurance.
CareCredit Financing
We also offer CareCredit as a financing option. CareCredit will give you’re the flexibility and convenience to manage your dental expenses to your individual budgets. We offer as little as no interest for up to 12 months. Using care credit helps you reserve your cash and credit cards for other expenses. It is easy to apply for Care Credit. In the office, we will help you apply and you will receive an answer almost immediately. If approved, you can begin treatment almost immediately.
Facts About Dental Insurance
As an optimal care dental practice, we strongly believe our patients deserve the best possible dental services we can provide. In an effort to maintain a high quality of care, we would like to share some facts about insurance with you.
Fact #1. Your dental insurance is based upon a contract between your employer and the insurance company. Should questions arise regarding your dental insurance benefits, it is best for you to contact your employer or insurance company directly.
Fact # 2. When dental insurance plans first appeared in the early 1970’s, most plans had a yearly maximum of $1,000. Today most plans still ONLY have an annual maximum of $ 1,000. Allowing for a conservative yearly rate of inflation, your yearly plan maximum should be in excess of $ 6,500.00 today. Your premiums have increased, but your benefits have not. Therefore, dental insurance is never a pay-all; it is only an aid.
Fact #3. You may receive a notification from your insurance stating that dental fees are higher than usual and customary. Insurance companies never reveal how they determine usual and customary, reasonable (UCR) fees. They are at least determined by taking some percentage of an average fee for a particular procedure in a geographic area.
Fact #4. Many plans tell their participants that they will be covered up to 80% or up to 100%, but do not clearly specify plan fee schedule allowances, annual maximum, or limitations. Please note that when an insurance company says they will pay a (% ) percentage of the fee, It will be a percentage off their UCR fee, not the actual provider’s fee.
Summary
- Fees for services rendered are the same charged to all patients for services regardless of whether the patient is covered by insurance.
- Your policy may base its allowance on a schedule which may or may not coincide with your provider’s fees.
- Insurance companies vary greatly in the types of coverage available.
- Benefits have nothing to do with fees charged.
- Insurance coverage is a contract negotiated between your employer and the insurance company. Your insurance benefits are determined by your employer and not by our office.
- You are financially responsible for your accounts. The insurance company, of course, is responsible to you the patient. We strongly suggest that you become familiar with the provisions of your dental insurance coverage. We will cooperate in any way that we can help you obtain maximum benefit.
