Office Policies
Welcome To Dr. Pratt's Office
OUR OFFICE POLICY
Welcome to our practice. In our continuing efforts to provide comprehensive dental care, we ask that you become acquainted with our office policy. If at any time you have any questions, please feel free to ask so that we may better serve you. All recommended treatments are in the best interest to our patients. We will not allow insurance companies to dictate treatment so therefore we will inform you of the fees before we perform all procedures. We will assist you in your payment options to help you receive the treatment that is necessary for your needs. Please note that no two mouths are alike; therefore, we will customize treatment to suit your individual needs. Also, we have developed our new web site which will be very convenient to access your account and information.
PREFERRED METHOD OF PAYMENT
For your convenience, we accept personal checks (with proper I.D.) cash, debits, Visa and Mastercard. As an added courtesy, we also offer a revolving line of credit through a third party, CareCredit (upon approval). There will be a thirty-five dollar ($35.00) returned check fee applied to your account in the event that the bank denies your check.
GENERAL APPOINTMENTS
We reserve appointment times especially for you and your specific dental needs. When you cancel on such short notice, other patients that need treatment cannot be seen and the time and money we pay to our staff and overhead is wasted. Therefore, in order to maintain our fees, we ask that you kindly give us a 24-hour notice if you are unable to keep your appointments.
SPECIALITY APPOINTMENTS (Oral Surgery, Periodontal Procedures, Implants, Crowns & Bridges)
These "big" appointments require large spans of time set aside especially for you. We do ask for a 72-hour notice if you are unable to keep these appointments. We charge a sixty dollar ($60.00) broken appointment fee for these "big" appointments.
PAYMENT AGREEMENT
In the event that there is a default of payment on any amount due, and your account is placed in the hands of an attorney or collection agency, you will be charged an extra fee equal of the processing fee as well as any collection agency/attorney fees.
DENTAL INSURANCE
We accept an assignment of estimated insurance benefits as a courtesy to our patients, provided that you submit a benefits booklet or a valid insurance card. Please note that your dental insurance is a contract between you and the insurance company, not between your dentist and the insurance company. Our usual and customary fees are a reflection of our commitment to provide you with the best material and quality of dental care. If for any reason your insurance company fails to pay for services rendered, you are responsible for all payments.
I have read and agree to terms listed above.
Signature of Patient/Parent/Guardian Date
Signature of Office Representative/Dentist/Staff Date