Dr. Kay

Thank you for choosing Dr. Kay’s office for your dental needs. Every person’s financial situation is different and for this reason a variety of payment options are available. Dental treatment is an excellent investment in an individual’s medical and psychological well-being. Financial considerations should not be an obstacle to obtaining this important, life-enhancing care. We are always available to answer your questions and/or assist you in any way we can.

For patients with dental insurance: We are happy to assist you in filing the necessary forms to help you receive the full benefits of your coverage. The insurance relationship constitutes an agreement between the carrier and the patient. As such, we can make no guarantee of estimated coverage or payment. However, please know that we will do everything possible to see that you receive the full benefits of your policy.

• Plan A: Payment in full on the day of each visit. To demonstrate our appreciation for patients who are prompt with full payment, we will extend a five percent (5%) reduction of the total fee, if paying with cash or check.

• Plan B: You may use your credit or debit card to make payment. We gladly accept MasterCard or VISA.

• Plan C: We are pleased to offer patients another extended monthly payment plan option through a dental financing company called Care Credit (800 365-8295 or www.carecredit.com ). Please see our financial coordinator prior to treatment for more details and to receive a loan application. The process is simple and fast, can be done online or over the phone

• Plan D: Our goal is to help you maximize your dental insurance benefits. As a courtesy, we are happy to bill your dental plan for services. Please remember that the contract itemizing your dental benefits is between you, your employer, and your insurance carrier. Regardless of coverage, your estimated co-payment is due in full the day of treatment. If your dental plan does not pay within 60 days of treatment, you must pay any outstanding balance and seek reimbursement from your dental plan. If your dental plan pays more than expected, you will receive a refund check within one week. Also remember that dental insurance plans are not designed to cover all of your dental needs. Rather, the amount your dental plan contributes towards your dental care is based on the plan selected and purchased by your employer.

Again, feel free to ask if you have any questions regarding the payment options described above. We thank you for trusting us with your dental care needs and hope that you will let us know if we can improve our service to you in any way.

• INSURANCE: Please provide our office with any booklets or other insurance information as well as your dental insurance card. We may accept assignment of insurance benefits at your first visit if we have first verified your current coverage. If we cannot determine your coverage we will ask for payment in full at time of treatment. Otherwise you will be asked to pay the deductible (if applicable) and any amount not covered. 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 insurance program.

• NO INSURANCE: Please be prepared to pay for your visit at time of service. If you would like to make monthly payments, please ask about our partnership with Care Credit. This plan benefits you most when paid within the time allowed as there is no interest. We will be happy to provide the information for application. If you pay by cash or check you will receive 5% off the treatment. For your convenience we also accept Visa and MasterCard.

• 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. You will be responsible for payment regardless of any insurance company’s arbitrary determination of usual and customary rates.

• CONFIRMATION/CANCELLATION OF APPOINTMENTS: If you find that you cannot keep an appointment please notify our office within 48 hours of the appointment so that we may use this time for another patient. We try to call and confirm all appointments prior to the appointment. If you miss you’re appointment we will charge you $25, and cannot schedule you another appointment until that has been paid. Then when you come to you’re next appointment that $25 will be put towards you’re account. If a second appointment is missed there will be a $50 charge, thereafter you will be required to pay for the complete appointment prior to doing the work.

• MAJOR SERVICES: We prefer to predetermine major dental work so that we may confirm what your insurance may pay. Once a predetermination is returned to us we will notify you by mail. Dr. Kay reserves Friday mornings for crown and bridge preparations so please plan your schedule accordingly. We also ask that you come prepared to paid you’re portion at the time of the appointment.

• ILLNESS: If a patient has been ill within 24 hours before appointed treatment, please call our office to reschedule. Also if you have any mouth sores (cold sores, canker sores) let us reschedule you for you’re comfort.

• MEDICATION: Please be sure to inform our office of any medications you are taking and any medical problems you may have.

• MINORS: We need the parent’s (or legal guardian’s) direct permission to render dental treatment. If you will be leaving you’re child we will need to have a phone number to contact you.