Davies Dental Financial Agreement

In our continued commitment to provide the highest quality dental care available to our patients and to have those services comfortably affordable, we are please to let you know that we offer multiple forms of payment. We accept, Cash, Check, Visa, MasterCard, Discover, American Express, and Care Credit.

We are committed to supporting you in understanding your dental health so that you will always be able to make the best choices.

INSURANCE

We understand that processing dental insurance can be a time consuming and complicated task. As an added benefit of using Davies Dental, we will be glad to process your dental insurance benefits for you.

You are fully responsible for the total payment of all procedures performed in this office; this includes any treatment that is not a benefit of any dental insurance that you may have. All services are due to be paid in full within sixty (60) days of the date of service, regardless of whether or not your insurance benefits have been received.

MISSED APPOINTMENTS & CANCELLATION POLICY

A fee of $125 will be charged for the following:

  • Missing your appointment
  • Rescheduling within 48 hours of your appointment.
  • Arriving late and your treatment needs to be rescheduled.

Appointment times are reserved especially for you and our team spends extensive amounts of time preparing for your visit. Broken and missed appointments prevent other patients from receiving the care that they need. If you find that you must change your appointment, we require a minimum of 48 hours notice so that we may accommodate other patients.

MONTHLY BILLING CHARGES

Monthly statements will be forwarded to you for the fees you are responsible for. All payments are due as indicated on the statement. Any payment made after the due date are considered late and will incur additional billing fees monthly.

Balance over sixty (60) days will incur a $5 monthly billing fee.

There is a $40 fee for all NSF checks returned to Davies Dental.

All delinquent accounts will be forwarded for collections. Any refiling fees, collection charges, court costs, and reasonable attorney fees will be added to an overdue balance.