Financial and Insurance Policy

We are so pleased that you have chosen our practice to take care of your oral surgery needs. We make every effort to deliver the finest care at the most reasonable cost to our patients. It is very important to us that we earn your trust.

In order to build a successful relationship with you and your family, your clear understanding of our Patient Financial Policy is important. As a part of a professional relationship, we kindly ask that you make your payment at the time service is rendered unless other arrangements have been made in advance prior to the procedure. For your convenience, we accept cash, checks, or credit cards.

We know that the cost of care can be confusing. We are happy to help you navigate your dental insurance and also give you an estimate of the charge for any procedure or surgery you may require ahead of time.

We offer the following financial options for our patients to pay for services within our office:

  • Cash or Personal Check (no third-party checks or postdated checks)
  • A $25 fee for any returned checks
  • VISA or MasterCard
  • Outside financing from a bank, finance company, or institution cooperating with our office
  • Insurance
    • Dental Insurance is usually filed for oral surgery procedures. In some cases, medical insurance will cover the removal of impacted wisdom teeth.
    • Proof of insurance is required at the time of consultation. If you do not have proof of insurance by either a form or card, you will be asked to pay for your visit and we will be glad to file your insurance once we receive the information.
    • Remember, for any medical insurance that is filed by our office, a referral form is required from the primary care physician, or the claim will not be paid.

Procedure Deposit:

A deposit will be estimated and due the day of our procedure. This is only a deposit. Once your insurance pays, there is usually a balance which you are responsible for paying. Our office will bill your insurance, if we do not receive payment from the insurance company within thirty days, you will be billed, and payment is expected. There will be a $125.00 fee charged for patients who do not give 24-hour cancellation notice.


In the event that the account, including any approved service charges, is placed in the hands of a collection agency or attorney, the patient (or legal guardian) agrees to pay an additional 40% of the balance due towards collection costs, including a reasonable attorney’s fee and court costs.

Service Charge:

In accordance with the terms of your contract, if the account is not paid within 90 days (after the service is rendered), the account shall be subject to a service charge of one and one-half percent (1 ½) per month which shall be compounded.

This financial policy helps the office provide quality care to our valued patients. If you have any questions or need clarification of any of the above policies, please feel free to contact us.

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