We appreciate your understanding that Dr. Shufflebarger does his best to provide excellent quality of care at reasonable market rates. Although we are in network with many dental insurance companies, we do not work for any insurance company and therefore the filing of any claims on your behalf is a courtesy to you as a result of your relationship you have with them. Please note we can not predict or guarantee what your insurance will cover and pay for any services you receive by Dr. Shufflebarger. You are ultimately responsible for all charges incurred for any services rendered at our office. This information is to assist with expectations with the financial aspects of our practice.
GENERAL PAYMENT TERMS
We provide payment estimates for your planned procedures so you are aware of any financial obligations prior to scheduling an appointment. Payment in the amount of 50% of the estimated portion you will owe is required at the time of scheduling. This is a non-refundable deposit. It guarantees your appointment and confirms that you intend to go forward with the procedure. By giving your credit card information as reviewed at the time of scheduling, you consent to this deposit and we will provide the necessary requested treatment as planned.
On the scheduled date of service, unless you elect to pay the full amount in advance of the appointment date, the remaining 50% of the estimated portion you will owe for the planned procedure is due. This will complete the amount we have estimated for you to pay for the planned treatment.
Sometimes there are changes that occur on the date of service and you elect to have additional work done. In this instance, we would provide an estimated amount for the procedure to you and collect once you have authorized us to proceed with the additional work on the date of service. If for some reason, there is less work than planned, we will provide the necessary credits back to you once the claim has been fully settled by any insurance payments.
We accept cash, cashier’s checks, debit cards, and credit cards. Specifically, we accept any Visa, Mastercard, American Express or Discover Card.
Regrettably, we do not accept personal checks.
We can not accept forms of credit such as Carecredit or Lending Club as we are not contracted to accept those forms of payment.
We do not offer any payment plans.
DENTAL INSURANCE
If you have dental insurance, we will be happy to submit a claim for payment to your dental insurance company on your behalf. You are required to provide your insurance information at the time of scheduling in order that your coverage can be verified. In the event you do not have your insurance information, or coverage cannot be verified, full payment is expected by you on the date of service. We will be happy to reschedule your appointment until a time when your insurance can be verified with your insurance company if you prefer.
We always encourage and are happy to submit Pre-Determinations to your insurance company to try and provide more of an expected amount of coverage and discern what they will provide towards the planned treatment. The insurance will warn us this is never a guarantee but it is the closest thing we have to determining an accurate price and what they will cover for you.
If you have dental insurance, payment of your deductible and co-payment is what is included in the estimated amount we provide to you. In the event your insurance co-payment is underestimated, you will receive a billing statement for any remaining money owed. In case of an overestimation, a refund will be issued to you or we can credit your account if you are involved in ongoing treatment. We do not keep balances on your account for future work unless you specifically tell us to do so.
Please note we do not “back bill” or “retroactively” submit insurance claims. If you later find that you have insurance coverage after the date of service, we unfortunately will not submit a claim to your insurance after the date of service and treatment was rendered.
MEDICAL INSURANCE
Since the procedures we provide are dental procedures, we do not submit claims to any medical insurance policies. Any billing by you to your medical insurance would be independent of our office. If you decide to submit a claim it is your sole responsibility to complete the claim processing and understand that our office will not be responsible or assist with any aspects of the medical insurance submission. On the date of service we can provide you with an itemized statement for the services rendered but we will not be able to provide any additional assistance for your choice to utilize your medical insurance. If you have any questions about any of the billing policies or financial information, please contact our office so we can be of help at (937) 543-6956.
