Smile Central Dental: 4980 Barranca Parkway Suite 206 Irvine, CA 92604
Smile Central Dental Financial Policy
Thank you for choosing Smile Central Dental as your dental care provider. We strive to provide the very best service to our patients in every way possible and are committed to your treatment being successful. Please understand that payment of your bill is considered a part of your treatment. The following is our Financial Policy, which we require you to read and sign prior to any treatment.
We consider our relationship with you to be of primary importance and will always make our recommendations based on what we believe is the very best treatment for you regardless of your insurance coverage or financial arrangements. For your comfort and convenience, we offer a wide range of financial options, and welcome your suggestions and questions.
Pay as You Go
FULL PAYMENT IS DUE AT THE TIME OF SERVICE.
You may choose to pay your obligation for each visit. We accept Cash, Cashier’s Check, Money Order, Visa, MasterCard, and Personal Check. There will be a fee charged on all return checks.
Two Payments (for fees over $1000.00)
Total patient obligation may be divided as follows: 50% due at the first treatment visit, with the remaining balance due upon completion of treatment.
Interest free payment plans with low payments up to 12 months. With good credit we can get fast approval by phone or internet. If insurance applies Smile Central Dental will accept assignment of benefits and deduct the “estimated” figure from the amount owed. Your financial policy with CareCredit is a contract between you and CareCredit; we are not party to that contract. Click here to apply for Care Credit.
Gradual Treatment Plan
FOR THOSE PATIENTS ON A LIMITED BUDGET. By prioritizing treatment, those patients who do not have dental insurance or on a tight budget can still complete their dental work by spreading appointments over several months.
The adult accompanying a minor and the parents/guardian of the minor are responsible for full payment. For unaccompanied minors, non-emergency treatment will be denied unless charges have been pre-authorized to an approved payment method at the time of service.
Smile Central Dental requires advance notification for any appointment that needs to be cancelled. Notice of 24-hours is required, in order to allow us time to fill the appointment slot. If you fail to give us adequate notice, or if you “no show” for your appointment, you will be charged a fee as follows:
- Unless cancelled at least 24-hours in advance, our policy is to charge for a missed appointment at the rate of a normal office visit, up to $75. However, the first missed appointment fee will be waived if you reschedule your appointment, and show up.
- Any missed appointments thereafter will be charged at $75 and will not be waived.
- Please be on time to your appointment. Arriving 15 minutes or later to your appointment will result in a $25 charge and your appointment will be rescheduled for a later date.
Please help Smile Central Dental serve you better by keeping your scheduled appointments.
There is a 1½ % finance charge (18% APR) on any unpaid balance carried for more than sixty days.
In the event of any legal action, by either party, to enforce the collection of fees for Smile Central Dental due under this agreement, the prevailing party shall recover reasonable attorney’s fees and costs. In the event of any costs incurred in the collection of fees (such as agency fees) due under this agreement, the additional cost will be added to the account.
Thank you for understanding the Financial Policy of, Smile Central Dental. Please let us know if you have any questions or concerns.
Smile Central Dental Insurance Policy
It is our pleasure to assist you in maximizing your insurance benefit by completing your claim forms. Our office utilizes the highest technology and transmits your claims and any attachments via electronic services. As a courtesy, in addition to filing the claim we will initially ask for your estimated co-payment. Please understand that it is only an estimate based upon the information available to us. Once your carrier has paid the claim, any remaining balance is your responsibility.
If your insurance company postpones payment for more than 90 days, we ask that you make the remaining payment while we work together to get the insurance company to pay the obligated amount.
To avoid any misunderstandings we wish our patients to know that all professional services rendered are charged directly to the patient and that patients are personally responsible for payment fees. Please note that the anticipated payments from the insurance companies are based upon estimates only. The patient’s share is due at the time of treatment. Please remember that the ultimate responsibility of payment of service remains with the patient.
Usual and Customary Rates
Our practice is committed to providing the best treatment for our patients and we charge what is usual and customary for our area. All insurance companies are not the same in what they consider to be usual and customary fees. You are responsible for payment regardless of any insurance company’s arbitrary determination of usual and customary rates. We recommend that you take the time to read over your policy and contract your carrier if you have any questions regarding your coverage.
Regarding Indemnity Insurance
Smile Central Dental will process any insurance claims as a courtesy to our patients. We, however, cannot guarantee that your insurance company will pay the “estimated” figure. The balance is your responsibility whether the insurance company pays or not. Therefore, the entire balance on an account remains always the sole responsibility of the patient. Your insurance policy is a contract between you and your insurance company. We are not party to that contract. Please be aware that some, and perhaps all, of the services provided may be non-covered services and not considered reasonable and necessary under your Dental Insurance Policy.
Regarding Insurance Plans where we are Participating as a Provider
All co-pays and deductibles are due at time of treatment. In the event that your insurance coverage changes to a plan where we are not participating as a provider, refer to above paragraph.
Thank you for understanding the Insurance Policy of, Smile Central Dental. Please let us know if you have any questions or concerns.