An attractive and comfortable
waiting room for our patients
Notice
Of Privacy
Practices
Office:
(252) 443-7331
Answering Service: (252) 443-8822
FAX (252) 937-2381
Financial
Policy
The following is our Financial Policy. You will be asked to read and sign
the statement prior to your examination and treatment.
Payment Responsibility
An ADULT patient (18 years and older) is responsible for his/her account. The
parent or guardian of a MINOR is responsible for that account.
We Accept Cash, Checks, or Visa, MasterCard,
Discover or Care Credit
Cash Accounts
Payment is due at time of service
Insurance Accounts
We will file your insurance. However, we require that a portion of the bill be paid
at the time of service. This portion is based upon an estimate of your deductible and
coverage. there may be a balance and this will be your responsibility.
Insurance pre-authorization for minor procedures may require re-scheduling your
appointment.
It is important that we obtain the correct insurance information, including an original
claim form, or copy of your card. Please remember that your insurance policy is a contract
between you and your insurance company. Also, be aware that some oral surgery procedures
may not be covered under dental insurance, medical insurance, or the Medicare program.
Usual and Customary Rates
We are committed to providing the best treatment for our patients We charge what is
usual and customary for our area. This fee is not based on an insurance company's
determination of usual and customary rates.
Missed Appointments
Cancellations are accepted if our office is notified at least 24 hours in advance.
Otherwise, additional appointments will be denied. Please help us serve you better by
keeping scheduled appointments.
Notice
Of Privacy Practices