ASSIGNMENT OF INSURANCE:
PAYMENT OPTIONS:
Savings Program for Prepayment In Full (benefiting Cash and Out of Network Insurance Patients): Our office offers a savings program for patients willing to pay for the entire cost of their treatment prior to treatment beginning. We extend a 10% savings for prepayment in cash and 5% for prepayment with credit card. For patients with out-of-network insurance, the savings program does require that you file and accept your own insurance. There is no assignment of benefit to our office. This option is available for treatment over $1000. We will continue to offer a cash discount for our patients who do not have insurance. For treatment less than $1000, the discount will be 5% (this is cash or check only) We will be happy to file and accept benefits for patients with out-of-network insurance but cannot offer a cash discount for this service. For patients with in-network insurance, we will continue to honor your discounted rates and file your insurance.
Outside Financing Options: Our office has contracted with a financing company so that we can offer you several attractive payment options. The qualification process is simple and can usually be completed within 20 to 30 minutes. You have your choice of the following options within this program:
90 days same as cash
6-12 month 0% financing
Overdue/Past Due Accounts: If your account becomes more than 90 days delinquent, Smith & Cole Dentistry reserves the right to turn your account over to an outside debt collector. Once your account has been turned over for collection, Smith & Cole will not be able to assist you with your account.
Dependents Age 18-26: We recognize that many of our patients aged 18-26 are covered by their parent/guardian’s insurance. We do require that each patient give us permission to discuss treatment and financial information with the financially responsible party. Once permission is granted, we require the parent/guardian to sign a responsible party agreement. This agreement states that the responsible party assumes liability for any treatment that we provide with the patient’s permission.