FINANCIAL POLICY FOR THE DENTAL OFFICE OF DR. ER-JIA MAO
This form explains to all of our patients the billing process only of the office -- much like a payment agreement for a credit card, or billing policies and procedures for utility companies. For the answers to any other questions you have, please ask any of our trained staff members -- we're here to help!
The primary goal of our dental practice is to provide the highest quality oral health care in the most gentle, efficient and enthusiastic manner. Since our practice is also a business with obligations that must be met, we ask that all patients pay for their treatment in full on the day of each visit to our office unless prior arrangements have been made.
We will do our best to give you a rough estimate of your investment in your dental health for each upcoming visit, based on your individual treatment plan. You will be given a very close estimate of your next visit's total bill. Please bring cash, check or credit card at the time of treatment. With a proper diagnosis and a timely treatment plan, most estimates we provide are accurate.
Outstanding balances on your account are discouraged, and must be cleared before the next appointment for any account member or within 30 days of treatment, whichever comes first. Appointments for non-emergency treatment may need to be postponed pending payment of outstanding balances. Amount due and not paid in full within 30 days will be charged interest at a rate of 1.5% per month in addition to a $5.00 monthly billing fee per statement.
Delinquent balances over 90 days old will be referred to Rainier Collection Services Inc. All referred accounts are marked "Inactive". In order to have your account "Reactivated", and continue to receive dental treatment in our office, the delinquent balance plus a "Reactivation Fee" of 50% of the delinquent balance referred to the collection agency will be charged to your account. Only after this total account balance has been paid in full can appointments be made and your account and patient status be reactivated.
A returned check fee of $40.00 (subject to change as bank fees increase) will be added to your account for any returned check. Before we accept another payment by check, the $40.00 fee plus full payment for the check that did not clear must be paid in cash, or by VISA, MasterCard, or Discover.
Your dental appointments are scheduled carefully. Time, trained personnel and dental equipment are reserved for each procedure. Missed appointments add to the cost of dental care when reserved facilities are left waiting empty. We request 48 hours advance notice for rescheduling your appointment. Your account will be charged a broken appointment fee of $50.00 for repeatedly missed appointments without proper notification.
OFFICE POLICY FOR PATIENTS WITH DENTAL INSURANCE
You need to bring your insurance card at your first visit and at any time your insurance changes.
You need to be aware that:
- We will always do our best to help you to maximize your benefits.
- Although we file claims for you as a courtesy, your dental insurance policy is a contract between you, your employer and your insurance company. We are not a party to that contract (we are not a participating provider).
- Your treatment plan is individually tailored, and is not based on your dental insurance benefits or lack of benefits.
- Not all services are covered benefits in all contracts. Some insurance companies arbitrarily select certain services they will not cover. It is your responsibility to thoroughly understand the coverage and exceptions of your particular policy. Coverage issues can only be addressed by your employer or group plan administrator. We cannot act as a mediator with the carrier or your employer.
- Our staff is trained to help you with questions you may have relating to how your claim was filed, or regarding any additional information your carrier may need to process your claim. Please, ask if you have any questions.
- As a courtesy to all of our insured patients, we will file your dental insurance claim forms. In special circumstances, a particular insurance company's benefit check can be sent to our office directly. In such cases, you are responsible at the time of treatment for payment to us of any applicable deductible and for your coinsurance portion. Any payments made directly to you by your insurance company on unpaid balances should be forwarded immediately to our office so that your account may be credited accordingly. Monthly accruing interest at the rate of 1.5% in addition to a billing fee of $5.00 per monthly statement can be avoided if your personal financial responsibility is clear within 30 days of your treatment, thereby eliminating the need for statements to be generated and mailed to you.
- Your claim will be filed immediately, and benefits are expected are to be paid within 30 days. The filing of an insurance claim does not relieve you of timely payment on your account. If the claim is not cleared by your carrier in 45 days, the unpaid portion will automatically become "self-pay" and a statement will be issued to you for the unpaid portion. You are responsible for any amounts your insurance company chooses not to pay, for whatever reason. Any amounts expected to be paid by your insurance company, but not cleared by them within 45 days become your responsibility and, if not paid in a timely fashion, will begin to accumulate interest at the rate of 1.5% per month with the billing fee of $5.00 per monthly statement. Please feel free to contact your insurance company regarding unpaid benefits. We will gladly provide you with a letter which would include all pertinent information which you may sign and mail.
We know you have many choices when choosing a Dentist in Seattle, WA so we have made requesting an appointment a simple process via our website. If for any reason you cannot keep a scheduled appointment, or will be delayed, please call us as soon as possible.
Insurance and Billing
We accept most traditional insurance plans, contact our office to verify acceptance of your plan. We accept checks, cash or credit cards. We are happy to file insurance for your reimbursement as long as you are free to choose your own dentist.