Patient Information
PATIENT RESPONSIBILITY
PERTINENCE
REFERRAL
REGISTRATION FORMS
REQUESTING SOCIAL SECURITY NUMBER
CANCELLATION POLICY
TARDINESS
PAYMENT POLICY
INDEPENDENT FINANCING
PREPAYMENT REQUIREMENT FOR DENTAL LAB WORK
DENTAL INSURANCE
INSURANCE PAYS SUBSCRIBER
EMERGENCY APPOINTMENT
INITIAL APPOINTMENT (NON-EMERGENCY)
TREATMENT PLAN
APPOINTMENT ORDER
APPOINTMENT CONFIRMATION
SCHEDULE CHANGES
APPOINTMENTS FOR FAMILIES
REFUSAL OF TREATMENT
RECORD TRANSFER REQUEST
QUESTIONS
DISCLAIMER
HIPAA NOTICE OF PRIVACY PRACTICES
PERTINENCE
REFERRAL
REGISTRATION FORMS
REQUESTING SOCIAL SECURITY NUMBER
CANCELLATION POLICY
TARDINESS
PAYMENT POLICY
INDEPENDENT FINANCING
PREPAYMENT REQUIREMENT FOR DENTAL LAB WORK
DENTAL INSURANCE
INSURANCE PAYS SUBSCRIBER
EMERGENCY APPOINTMENT
INITIAL APPOINTMENT (NON-EMERGENCY)
TREATMENT PLAN
APPOINTMENT ORDER
APPOINTMENT CONFIRMATION
SCHEDULE CHANGES
APPOINTMENTS FOR FAMILIES
REFUSAL OF TREATMENT
RECORD TRANSFER REQUEST
QUESTIONS
DISCLAIMER
HIPAA NOTICE OF PRIVACY PRACTICES
INSURANCE PAYS SUBSCRIBER
When a patient is covered by an insurance carrier that pays the subscriber, not the dental provider, the patient's account balance will be due and payable at the time of service.Insurance carriers that pay the subscriber, not the dental provider include, but are not limited to, Anthem, Delta Dental, Blue Cross/Blue Shield, and MetLife.
Some insurance carriers that pay the subscriber, not the dental provider, do not send a copy of the Explanation of Benefits, the explanation of the date of service dental benefits and payment, to the dental provider. To correctly apply payment to the appropriate patient, as well as allowing this office to keep a record of an insurance plan's benefit history, please provide this office with a copy of the Explanation of Benefits, each time the subscriber receives payment.