Insurance Policy & Assignment of Benefits

For patients with dental insurance only.

As a courtesy, we will educate you and file the forms necessary to see that you receive the full benefits of your coverage. Because your insurance policy is a contract between you, your employer, and the insurance company, it is your responsibility to make sure we have accurate and up to date insurance carrier information, restrictions of your policy, and billing information. Please understand that the treatment plan provided is an estimate of what your insurance may cover and can differ once claims are submitted. Please be aware some of the services provided may not be covered by your insurance provider. Services which are not covered, or downgraded and any remaining balance after insurance has paid their portion, are your responsibility. We will send you a statement in the mail and via text and any balance left unpaid after 30 days will be sent to collections and the cost of collections of any account will be paid by the patient. Failure to cooperate will result in legal action. A refund check or credit to you will be issued if insurance has paid more than what was estimated in your treatment plan.