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Financial Policy

Your Health is our first and foremost Priority. Dental care will always be rendered based on need and no other factor will affect the quality of that care.

 

 BY BOOKING AN APPOINTMENT YOU ACKNOWLEDGE THAT YOU HAVE READ & AGREE TO ALL OF OUR POLICIES AND PROCEDURES.

 

This is an agreement between Sara K Dean as a creditor and the patient/debtor named on this form. By executing this agreement, you are agreeing to pay for all services that are received.

 

MONTHLY STATEMENT:

All patient balances are due immediately after treatment is rendered. Please ask us if you are interested in learning about third party financing, which may allow you to finance your treatment in low monthly payments. Should a balance accrue on the account a statement will be sent and payment is to be made, in full, by the date on the statement. If payment is not paid within 30 days interest may be applied to the entire account balance. A revised statement with the new account balance, payable immediately, will be sent.

 

INSURANCE:

Dental insurance is a contract between the patient, their employer (if applicable) and the insurance provider. Submitting claims for payment to the insurance provider is a courtesy provided by the dentist, not an obligation.

 

Ultimately, the patient is responsible for any treatment that is unpaid by the insurance provider. We accept most PPO insurances. If there is dental insurance on the account, the patient understands that the practice has established the patient balance based on the information provided.

 

Final treatment payment is subject to the terms and conditions of insurance provider on the date of service.

 

As such, until payment is received from insurance provider, no patient payment is final. We do not accept any HMO plans, and we do not accept Medicaid/Medicare plans.

 

Note: If your insurance changes, please provide the new information 72 hours prior to your dental appointment.

 

Financial Responsibilities:

As a patient of Sara Kohen Dean, you understand that you are responsible to pay in full at the time any service is rendered.

 

We accept most major credit or debit cards: MASTER CARD, DISCOVER, VISA, CASH or CHECK and Care Credit.


 

A $35.00 return service fee will be charged for any check that is returned for insufficient funds.

  

CareCredit:

For those who are interested, CareCredit provides little- to no-interest payment plans that help spread out the cost of your dental treatment. Applying for CareCredit can be done online or at our office with the help of our office team. To learn more about CareCredit or any of our financial policies, we invite you call or visit the office. 


CANCELATIONS:

We require clients to provide us with at least 48 hours’ notice (within business hours) if you are unable to keep the time, we have reserved for your 1 hour or less in length appointment any cancellation/no- show or rescheduling less than 48 hours prior to your appointment will result in a cancelation fee of $50.00.

 

FOR APPOINTMENTS TWO HOURS OR LONGER IN LENGTH, THE GREATER OF $250.00 OR 50% OF THE FEE ESTIMATED IS PLACED AS A DEPOSIT ON THE RESERVED TIME.

 

The deposit will be applied towards the upcoming treatment’s fee. If insurance is a primary form of payment and expected to pay more than the deposit, a credit will be issued the day of your procedure.

 

A two-business day notice is required in circumstances of rescheduling (due to closure, Friday, Saturday, and Sunday are not business days).

 

If insufficient notice is not provided or other priorities arise so that you prefer to forfeit the deposit, the deposit is applied to the fixed cost of practice operations and an additional deposit will be reserved for the next appointment.

 

PATIENTS’ FAILURE TO KEEP APPOINTMENTS

IMPORTANT

We have more patients who need dental care than we often have room in our daily schedule to provide. It is the inevitable result of the fact that we care about our patients dearly and prove it every day.

 

When a patient does not show up for their appointment or cancels too close to their scheduled time, we are unable to fill this appointment time with another patient who desperately needs dental care. This policy is our attempt to ensure that both you and other patients receive the dental care that is needed.

 

After 3 consecutively missed appointments, cancelations/reschedules the patient will be dismissed from the practice. If you are more than 15 minutes late for your service, we may not be able to accommodate you. In this case, the cancellation fee will apply.

 

PATIENT RECORDS:

Florida law requires that we keep your dental records for a period of 7 years. We will gladly send a copy of your records to another doctor free of charge should you relocate or wish to change dentist for any reason. All you need to do is fill out a release form that authorizes us to send your records elsewhere and provide us with 48 hours to process the request.


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Sara K. Dean, DMD
Creating Beautiful Smiles

Ormond Beach Dentist, Dr. Sara Dean is a dental professional dedicated to General, Family & Cosmetic Dentistry such as Dental Exams, Cleanings, X-rays, Fluoride, Dental Makeovers, Teeth Whitening, Veneers, Crowns, & more. Please come and visit Ormond Beach, FL dentist Sara Dean, DMD.