New Patient Registration
Please click on the New Patient Forms hyperlink below and then complete the patient registration forms prior to your first appointment. We are looking forward to seeing you soon. Thank you
Payment for services is expected at the time service is provided. Cash, checks, and credit card payments are welcome. Extended payment programs are available through third-party financing, Care Credit. An in-house membership solution, illumisure® is an available option for those without insurance.
If you have dental insurance your dental benefits are based upon a plan contract made between your employer and an insurance company. Dental Elements is not responsible for and can make no guarantees as to the coverage you dental insurance will provide. If you have any questions regarding your dental benefits please contact your employer or insurance company directly. Dental benefit plans will never pay for completion of your dental care. Insurance companies cover what they decide is necessary, not necessarily what your dental health needs. Consider insurance a coupon, as it is only meant to assist you.
We currently accept most insurance plans. Your patient portion and insurance estimates are provided as a courtesy. Please provide us with accurate and current insurance information to expedite our process. Payment by a given company does change; therefore it is impossible to give you a guaranteed quote at the time of service. Your portion is based upon the most up-to-date computerized information we have, but it is only an estimate. In the event that your insurance carrier pays less than the estimated amount, you are responsible for the unpaid balance. Several insurance companies offer alternative benefits for some services, therefore the fee differences will be charged to the patient.
If you would like to know your exact insurance benefit, we will happy to file a “pre-treatment authorization” with your insurance company prior to treatment. This does delay treatment but will give you the exact out of pocket figures you may require.
We file your primary insurance as a courtesy. If insurance does not pay within 90 days, Dental Elements, reserves the right to request payment from you in full for service and let you collect the insurance funds that are due to you. This occurrence is rare but it is important that you recognize that the insurance you have is a legal contract between YOU and the insurance company. Ultimately, you are responsible for all charges incurred in our office.
The coverage of secondary dental insurance changes. As a courtesy we will file secondary insurance claims for patient reimbursement only. Secondary insurance does not guarantee payment and is subject to different coverage rules. Therefore, your patient portion estimate is based upon the primary insurance. Secondary coverage does not mean 100% treatment coverage, with no patient payment responsibility.
Financing shouldn’t prevent you from getting the dental care you need now. If you do not have dental insurance Dental Elements offers easy affordable monthly payments through an in-house membership solution with membership advantages through illumisure®. It is quick and easy to join and you can even join before coming to the office. Click here to join now and start benefitting today.
In the event that your dental insurance carrier does not cover your treatment, Dental Elements offers payment options including financing for qualified patients through Care Credit. It is quick and easy to apply for financing. You can even do it from home. Click here to apply now.
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