Spruce Pine Dental Arts
DENTAL BENEFIT PLANS
in any business, Spruce Pine Dental Arts maintains business policies that
help us operate our business efficiently and effectively for our dental
patients. First and foremost, we have a
personal and professional relationship with you (the patient). Professional services are rendered and
charged to you, NOT YOUR DENTAL BENEFITS COMPANY. We file dental benefit claims for our
patients. However, you must provide a
copy of your dental benefit card. If you
have had changes in dental benefit since your last visit, you are responsible
for providing the correct dental benefit information to our office. If we cannot verify your dental benefit information
at any visit, you are responsible for paying the full amount of charges at the
time of service. In this event, we will
provide you with the information necessary to file your claim. It is very important that you understand the
specifications of your dental benefit coverage PRIOR to receiving dental
treatment at Spruce Pine Dental Arts.
Please understand that you are
personally responsible for payment of all dental services delivered to you by Spruce Pine Dental Arts. Our
business agreement is with you. You will
be responsible for all dental charges not paid in full or paid in a timely
manner by your dental benefit plan.
will file your primary dental benefit claim(s) for you. All deductibles and co-payment amounts not
covered by your dental benefit company are expected in full at the time of
service. You are responsible for knowing
what service your plan covers and when your services were last rendered. Dental benefit companies do not guarantee
payment on all services. Fees and coverage
information quoted by Spruce Pine Dental Arts is based on an estimate
arrangements for dental services must be made prior to starting any dental
treatment. Spruce Pine Dental Arts will not enter into disputes with dental benefits companies regarding unpaid
claims. It is the patient’s
responsibility to ensure that all claims are paid. It is also the patient’s responsibility to
follow-up on any unpaid claims that have exceeded 30 days. You will receive a monthly account balance
statement from Spruce Pine Dental Arts regardless of what has been paid
or expected from your dental benefit company.
This account balance statement will reflect what you owe to Spruce Pine Dental Arts. If your dental
benefit company has not paid on your account within 60 days, you are
responsible for the unpaid balance. Accounts
that are 60 days past date of service will be subject to a billing charge for
each statement sent (there is no charge up to 60 days.) and an interest charge
of 1.5% per month (18% per year). Accounts that are sent to collections will be
charged a 29% collection fee and mailing fee in addition to all statement fees
and interest. If your account is not paid within 90 days, your account will be
turned over to a collection agency, future appointments will be cancelled, and
Dr. Townsend and team will no longer provide dental services for you as a
patient of Spruce Pine Dental Arts.
DENTAL FEE SCHEDULES AND
USUAL, CUSTOMARY, REASONABLE (UCR) FEES
Spruce Pine Dental Arts’s dental fees are based on our dental services provided
to you, and our fee schedule is calculated according to dental community UCR
fees. Dental benefit companies’ UCR fee
schedules are determined by dental benefit companies, and do not always match
the UCR fee schedule of area of dentists.
Therefore, dental benefit companies may or may not pay the full fee(s)
charged for your dental services by Spruce Pine Dental Arts. You are responsible for understanding what
your dental benefit will pay regarding your dental treatment. Spruce Pine Dental Arts provides dental treatment to you based on your dental
needs and your elected option of treatment – not on what dental benefit
companies will pay on that treatment.
You are responsible for any fees not paid in full by your dental
benefits company. We accept cash, checks, Visa, Mastercard, and Discover.
Returned checks are subject to a charge of $20.00. We offer financing through
Care Credit, a program requiring participating patients to complete a short
application to receive approval for funding. Please inquire at the front desk
if interested in using this form of payment. The program contains no application fee and no interest for 180 days.
time is valuable to us and our patients!
Our doctor and dental hygienists have very efficient daily
schedules. Therefore, we respectfully
request that you inform us at least 24-48 hours in advance if you are unable to
keep a scheduled dental appointment. If
we do not receive at least a 24 hour notice, if you arrive late for the
appointment, or if you do not show for the appointment, a broken appointment
service charge may be billed to your account.
This fee will not be covered by your dental benefits plan. After a broken appointment, it may be difficult
for you to schedule another appointment in the practice before a six week
waiting period. Should you break more
than three appointments, our doctor/team can no longer provide dental services
for you as a patient of Spruce Pine Dental Arts.
is your responsibility to inform Dr. Townsend’s team regarding changes in your
address, phone number(s), employment and dental benefits. THANK YOU!