Dental Insurance & Financial Information Sunnyvale

Our Office Financial Policy

Payment for Services

Estimate of Treatment: Before any dental care is provided, you will receive a detailed estimate of treatment to be performed.

Direct Payments

1. Payment in full: Payment for dental services will be collected in full when you arrive for your appointment. It is your responsibility to inquire regarding your approximate payment for your appointment, so you can arrive prepared to pay in full. When payment is made in advance and in full for treatment over $1000 we offer a 10 % bookkeeping courtesy discount for paying by cash or check or a 6% bookkeeping courtesy discount for paying by credit card. All checks will be validated against your drivers license and a check verification system. 2. Installment payment: Our office policy does not allow us to extend credit. For treatment over $300, you may qualify for an interest free retail dental loan through an outside financial institution. This will help you spread your payments over a period of up to 12 months! Simply request and complete a short application. Most approvals can be obtained in a few minutes. Firm financing must be secured prior to your appointment. Accepted methods of payment are cash, checks, most ATM cards, Visa, MasterCard, Discover, and American Express.

Patients with insurance

Please understand that the entire bill is ultimate your responsibility. As a courtesy, we will be happy to bill your insurance company for your care and give you credit for the estimated insurance payment amount. Just be aware that the actual insurance payment may vary greatly from estimated amount. Estimated co-payment and deductible will be collected at EACH appointment. We can not bill you for the co-payment or deductible. Treatment estimates are not a guarantee of payment. We base this "educated guess" on the information you have supplied to our office. It is your responsibility to make sure your eligibility continues throughout your treatment and to familiarize yourself with your insurance benefits, such as your effective date, deductible, and co-payments. Account reconciliation and final bill. Please understand paying your estimated co-payment does not mean that your account is paid off. If your insurance company fails to make payment within a reasonable 60 day period of time, you will be responsible for the full amount owed. It is therefore advised that you contact your insurance carrier to follow up on the payment. Upon receipt of the insurance payment, we will reconcile the account and a final bill will be rendered. Final payment is expected within 14 days. Should there be an overpayment upon reconciliation; a refund of any difference will be sent to you. Occasionally, an insurance company will send a payment to a patient. If this occurs, you agree to bring us the check with the attached stub. Information on the stub is very important!

Additional Charges

• Late cancellations - if not cancelled prior to 48 hours before scheduled appointment: $25 per each half hour.
• Broken appointments - if you do not show up for a scheduled appointment: $40 per each half hour.
• Returned checks - for any reason: insufficient funds, closed accounts, etc: $25 per occurrence.
• Overdue accounts & Late fees - any payment received more than 14 days after the due date: $25 per occurrence.
• Account over 60 days - will receive a monthly service charge of 1.5% (18% per annum).
• Account over 90 days - are submitted to the Collection Bureau unless prior arrangements are made.