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Office Hours
| Monday |
9:30 am - 6:00 pm |
| Tuesday |
9:30 am - 6:00 pm |
| Wednesday |
9:30 am - 6:00 pm |
| Thursday |
9:30 am - 6:00 pm |
| Friday |
9:30 am - 6:00 pm |
| Saturday |
8:00 am - 3:00 pm |
| Sunday |
Closed |
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Financial Agreement, Payment Options
Thank you for selecting My
Children's Dentist Professional Corporation
for your child's dental care. We are
committed to providing excellent dental care
with concern for your child's personal
needs. We ask that you read and sign this
financial agreement statement prior to
treatment to assure there is full disclosure
of payment options and expectations. Our
financial policy allows us to continue to
provide high quality service without
increasing our fees to cover excessive
billing and collection costs.
Insurance Benefits:
We are in Network with all
major Commercial Insurance Companies
In Network Benefits:
The cost of the
treatment that is not covered by your
insurance company is due at the time of
service. We are happy to complete and submit
insurance forms on behalf of the patient. We
cannot, however bill your insurance company
unless you provide us with your correct
insurance information.
My Children's Dentist
Professional Corporation will wait for your
insurance payment to be process and sent
back to us. The entire account balance
remains your responsibility. The adult
accompanying the minor (under age of 18) is
responsible for full payment of the services
provided.
The amount quoted on your
treatment plan is estimates only. As
per your insurance company's policy, your
eligibility for benefits is not a guarantee
of coverage as an actual benefit payment.
Some or all of the services we provide may
not be a covered benefit and your insurance
company may only pay for a portion of very
basic care.
As with many dental plans,
your plan may contain certain exclusions
and/or limitations. You should refer to your
plan booklet for complete plan details.
Patients Using Insurance
Benefits:
Please note that the
insurance portion is also your
responsibility. Any amount not paid by your
insurance company becomes your obligation.
Out of Network Benefits:
The cost for the treatment is due to the
time of service. We will submit the dental
claim for the patients and the insurance
company will refund the patient in agreement
with you contracted fees.
Financial arrangements are
available upon request. Please ask about our
Care Credit Financial options.
Payment Method Available
are: Credit cards: MASTERCARD, VISA,
DISCOVER, AMERICAN EXPRESS. Payment plans
are all process through CARE CREDIT please
ask for an application, PERSONAL CHECKS:
(RETURN CHECK FEES: $25.00)
For the courtesy of other
patients who are waiting for appointment
times, please note, we require a 24 hour
notice to change or cancel an appointment to
avoid a charge.
Cancellation fees:
$65.00 without 24 hour notice
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