The following payment option are available:

A) Prepay Courtesy:
A Prepayment courtesy of 5% ( 10% if Senior Citizen, over 60 ) will be subtracted from the total patient obligation ( not from any portion due from insurance company ) if the patient obligation is paid in full at the first treatment visit. This option is available only if the total fee is greater than $2000.00.
 

B) Three Payments Zero Interest
Total patient obligation may be divided as follows: 50% due at the first treatment visit, with the remaining balance split into two equal payments, due 30 and 60 days after the first treatment visit. This option is available only if the total obligation is greater than $ 1,000.00 ( if less than $ 1,000.00, the full amount is due at the initiation of any procedure ). Note: balance payments will be written at the initiation of treatment, post-dated for 30 and 60 days-- our guarantee: If a post-dated payment is deposited prior to the date on the face of the check ( or credit card slip ) we will credit your account for an amount equal and in addition to that payment!
 

C) Five Equal Payments Zero Interest
Total patient obligation may be divided as follows: Five equal checks (or credit card slips), post-dated for five consecutive months. The first visit will be scheduled on or after the date of the third payment. This option is available only if the total fee is greater than $ 2000.00.
 

D) Pay as You GO.
You may choose to pay your obligation for each visit, at the visit.
 

FORMS of PAYMENT and BALANCES DUE
In order to facilitate access to the very best health care possible, you may choose from any of the following ( including any combination thereof ): Visa, MasterCard, American Express, Discover, Cash, Money Order, Personal Checks, or up to 6-month Financing ( see above ). Balances >60 days will incur a finance charge of 18APR.
 

INSURANCE
It is our pleasure to assist you by completing your claim forms. If your carrier is up to date ( in over 70% of the cases), the claims will be transmitted via computer modem before the end of the treatment day! As a courtesy, in addition to filing the claim, we will initially ask you only for your estimated copayment. Please understand that this is only an estimate, and is based upon the information available to us.

The range of benefits depends solely on what your employer wishes to purchase. Some plans may cover as little as 30% or as much as 100% of dental services, with most falling in the 40% to 80 % range.

Some plans base the amount of benefit on a schedule of fees arbitrarily developed by insurance companies. For this reason, you may receive a lower percentage than the reimbursement level indicated in your dental plan. For example, if your plan states that it will pay 80% of the cost of a specific treatment, it means 80% of the fee arbitrarily determined by the insurance company and not the actual fee charged by our office.

The financial obligation for dental treatment is between you and our office. The insurance company is responsible to you, and not to our office. We will assist you in any way that we can ( including our brand new high tech electronic claims submission ).Once your carrier has paid the claim, any difference will be due upon receipt of our statement. If for any reason, we have not received your insurance carrier’s payment 90 days after the claim, the remaining balance will be due and payable by you, and subject to 18APR.

CREDIT CARDS

CARE CREDIT

As a service to our patients, we are pleased to offer the reCredit card, North America's leading patient payment program. CareCredit has a full range of pa




Stuart A. Greene DDS-FAGD
2009 Birdcreek Terrace Temple, TX 76502 254.773.9007 | Fax 254.773.8051
©2007 Stuart A. Greene, DDS-FAGD | Online since 1996 | Updated Continuously