OFFICE POLICY AND FINANCIAL AGREEMENT

 For the convenience of our patients, the following office policy and financial agreement has been established for your review.
 
 
Cash / Check / Credit Card
A 10% accounting reduction is offered for treatment planned services.
 
 
Credit Cards
We accept VISA, MASTERCARD, DISCOVER, and AMEX.  We offer these to allow you the most convenience in taking care of your account.
 
 
Dental Insurance
As a service to our patients, we will file your dental insurance via electronic claims.  We work with your insurance company to provide the most accurate estimate of your co-pays.  It is the patient’s responsibility to provide the correct insurance information at the first visit.  Payment in full is required at the time of service for all non-insured patients.   Insured patients are responsible for, and should be prepared to pay all amounts not to be covered by the insurance estimate.  With insurance plans paying only a portion of treatment cost, we can only estimate what your insurance company will pay.  The maximum time allowed for an insurance payment is sixty days.  After sixty days, the patient is responsible for the entire balance.
 
 
Payment Plans
We have made arrangements with the Care Credit Company to provide payment plans.  This allows you to complete your dental work without delay and make relatively small monthly payments.  Care credit is used for treatment over $300.  Applications are available and approval can be determined within ten minutes.  For your convenience you can also apply online at www.carecredit.com
 
We also offer a financial option that requires a down payment followed by monthly payments automatically withdrawn from a bank account.  Please ask about this option that can be tailored for your specific needs.
 
 
Cancellations
As a courtesy to all patients we ask that a forty-eight hour notice be given for a cancelled appointment.  If we have not received sufficient notice, a charge may be applied to your account.
 
 
 

First Impressions Family Dental Care

522 State Road 32 East

Westfield, IN 46074

info@firstimpressionsdental.com

317-867-5511

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