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Financial Agreement

Thank you for choosing Dr. Tim Kirkpatrick's dental practice. Our primary mission is to deliver the best and most comprehensive dental care available. We would like to make your dental treatment as affordable as possible and strive to help you understand your treatment needs and financial responsibility prior to your first treatment appointment. We offer several payment options and have the following financial policy in place.

Payment Options:

Cash, Check, Visa, MasterCard, Discover and American Express

Care Credit - you may use a third party, no interest financing option called Care Credit. Applications for this program are available online at www.carecredit.com or applications can be obtained from our office manager. She would be very happy to explain this awesome financing program to you.

We offer a 5% discount to those patients without insurance for cash or check payments in full at the time of your treatment. Seniors in a similar situation receive a 10% discount.

Patients fortunate to have dental insurance benefits are required to pay that portion of their treatment not covered by insurance at the time of treatment.

Patients with dental insurance benefits:

As a courtesy to our patients, we are happy to assist in obtaining your maximum insurance benefits. Please note we accept many dental insurance plans. We will do our best to "estimate" your insurance coverage with the information provided to us. You are responsible for knowing your plan's deductibles, yearly maximums, limitations and waiting periods, although we will try to help you out with these factors. Please note that we accept many different insurance plans and they all have limitations and exclusions which ultimately affect your out of pocket expense. Our goal is to provide you with the best dental care for your particular situation, not to match dental treatment with what the insurance plan covers. Insurance coverage is a benefit to help you pay for dental work, not a pay all for what is best for the individual person. In fact, most insurance companies cover the cheapest treatment in order for them to keep their premiums low. We look after you, they tend to look after themselves.

Our office manager is happy to help you with your insurance benefit and will gladly verify what your particular coverage is with our insurance company. Please remember, you are responsible for deductibles and any expense not covered by your insurance policy at the time of treatment. Please also note that if you have been to another dentist or specialist during the course of a year, this may alter your ultimate payment to us. We have no way of tracking those services. If by chance your insurance company does not pay for services within 60 days from the date of service, the balance is due from you. You may then receive reimbursement directly from your insurance company.

Unfortunately, many insurance companies actually pay less than what was initially expected, even though treatment coverage is verified. The benefits paid are determined by how much your employer pays for premiums. We are happy to submit additional claims for you and help you receive your benefits, however, please know that we cannot take on the responsibility for collecting your benefits or negotiating benefits that are disputed.

Lastly, finance charges of 1.0% will be assessed on ALL balances after 60 days. Ultimately, you are responsible for payment of all dental treatment fees for yourself, spouse and dependants. Please notify us if you family circumstances change, your insurance plan changes, group numbers change, or any other insurance change occurs. We cannot be responsible for tracking a change in your plan or family situation. Insurance companies have specific rules when it comes to parent and step parent relationships and who is responsible for the child's coverage.

A fee of $25.00 is charged for returned checks.

If you have any questions, please do not hesitate to ask. If you share our belief in quality dentistry - the best dentistry we can possibly do - then we'll find a way to make it a part of your life.