Patient Form Downloads
NEW PATIENT HEALTH FORM
We are committed to providing you with the best possible care and are pleased to discuss our professional fees with you at any time. Your clear understanding of our financial policy is important to our provider-patient relationship. If at any time you have any questions or concerns regarding our fees, financial policy, or you responsibilities please feel free to contact us.
In-House Dental Savings
For our patients without dental insurance we offer our In-House Dental Savings Plan including bi-annual cleanings and discounted fees.
If you do not have insurance, proof of insurance, or participate in a plan that will no honor an assignment of insurance benefits, payment is due at the time of service.
We accept cash, checks, Visa, Master Card and American Express for your convenience.
The parents or guardians of unaccompanied minors must make arrangements for payment of services prior to the time of visit.
Please remember that your insurance policy is a contract between you and you insurance carrier. We will bill your insurance and help you receive the maximum benefit under your policy. We do expect patients to be interactive and responsible for communicating with your insurance carrier on any open claims.
It is your responsibility to provide all necessary insurance eligibility, identification, and authorization and to notify our office of any information changes as they occur. It is the patient’s responsibility to know if our office is participating or non -participating with their plan. Failure to provide all required information may necessitate patient payment for all charges.
Please be aware that insurance carriers may try to limit their financial liability with arbitrary limits, exclusions, or reductions such as reasonable/customary/usual reductions. Our fees are well within such ranges and although we will assist in the filing of an appeal, if these limitations are imposed, you as the patient are responsible for remaining fees.
Cramer Dental strives to accommodate our patients by providing convenient and prompt appointments. A designated amount of provider and staff time is reserved for each procedure. Last minute cancellations or patients who do not show up for their appointment cause significant disruption to the pre-arranged process and often delay other patients from receiving the treatment that they require.
Effective immediately, all patients who do not give at least 24 hours cancellation notice or who do not show up for the appointment will be billed a $75 no show/late cancellation fee. This amount is not billable to your insurance company and is considered a self pay liability.
For those needing extensive treatment we also offer Care Credit as a payment plan service.