Financial Information  (for Oral Surgery Patients)

Thank you for choosing Brian K. Smith, D.D.S., M.D., Inc. as your health care provider. We are committed to providing you with the best possible care and we understand your interest in the cost of quality dental and medical care. Our fees reflect the range of our services and the resources needed to complete them. They are comparable to fees charged by other specialists in this area. Please ask if you have any questions about our fees, financial policy, or your responsibility.

PATIENTS WITHOUT INSURANCE COVERAGE

It is the policy of this practice that payment in full is due on date of service.

PATIENTS WITH INSURANCE COVERAGE

Insurance is a contract between you and your insurance carrier. Unless you are a member of a specific PPO plan with which we participate, we are not a part of that contract. We will submit a claim to your insurance as a courtesy a maximum of two separate times per claim. We will not become involved in disputes between you and your insurance carrier regarding deductibles, co-payments, covered charges, secondary insurance, or the usual and customary determination of fees. THE ULTIMATE RESPONSIBILITY FOR THE AMOUNT DUE IS THE PATIENT’S.

CO-PAY/CO-INSURANCE

We do our best to verify your benefits with your insurance company in advance of your surgery. If we are able to verify benefits, the co-pay quoted to us by your insurance company plus any deductibles is due in full on the date of surgery. Please realize, however, that even if your benefits have been verified in advance, that is not a guarantee of benefits to be paid. Therefore, after the claim is submitted and a response is received from your insurance company, additional payment may still be due from you.

If your insurance company hasn’t paid your claim in full within 45 days, the balance due becomes your responsibility. To keep that from happening, we ask that you keep in contact with your insurance company regarding your claim. If payment is received from your insurance company after you have paid the balance in full causing an overpayment, you will receive a refund after our month-end processing (approximately the middle of the following month).

If we are unable to verify your benefits prior to your surgery, our policy is to collect 20% of the total due on the date of service. As stated above, once a claim is submitted and a response is received from your insurance company, additional payment may still be due from you.

If you have dental/medical benefits, but do not come prepared with your benefit information, FULL PAYMENT WILL BE DUE ON THE DATE OF SERVICE. If you provide us with your benefit information at a later date, we will be glad to bill it for you at that time.

The following financial options are available: CASH, CHECK, VISA, MASTERCARD, DISCOVER

*INTEREST FREE FINANCING (subject to approval)

* Ask the front desk coordinator for an application
Approval can be received in as quickly as 15 minutes!
(This method must be handled in advance of the surgery date)