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Office Policies
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First Visit
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Patient Forms
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Payment Options
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Appointments

Your scheduled appointment time has been reserved specifically for you.  We request a minimum of 24-hours notice if you need to cancel an appointment. We are aware that unforeseen events sometimes require missing your appointment. However, after missing a second appointment without notifying us in advance, you are subject to being charged a late fee.

We plan in advance to ensure that you are seen on-time and that we address all of your needs. We ask that our patients help us maintain our schedules by being prompt for each visit. In the event that you want us to address a problem that we are not expecting, alerting us in advance of your appointment will assist us in addressing all of your concerns during your visit.

Insurance

Our office is committed to helping you maximize your insurance benefits. There are over 150 dental insurance companies, and policies vary for each employer. We can contact your insurance company and estimate your coverage in good faith, but cannot guarantee your exact amount of coverage due to the complexities of insurance contracts.

We are happy to request pre treatment estimates from your insurance company upon your request. Please remember, pre treatment estimates take 4 to 6 weeks to receive back. If you want treatment to be completed by a certain date, please schedule your dental examination early enough to allow time for your insurance estimate to be processed.

As a courtesy to our patients, we bill insurance companies for our services and apply insurance payments to account balances due. Your estimated patient portion must be paid at the time services are performed.

Statement of Privacy Practices

Our Office is dedicated to protect the privacy rights of our patients and the confidential information entrusted to us. The commitment of each employee to ensure that your health information is never compromised is a principle concept of our practice. We may, from time to time, amend our privacy policies and practices but will always inform you of any changes that might affect your rights.


We use and disclose the information we collect from you only as allowed by federal and state law. This includes issues relating to your treatment, payment, and our healthcare operations. We may disclose health information to notify or assist in notification of your location, your general condition, or death. We may use or disclose health information to appropriate authorities about possible abuse or neglect. We may disclose to military authorities the health information of armed Forces personnel under certain circumstances.


Your personal health information will never be otherwise given to anyone – even family members – without your written consent. You, of course, may give written authorization for us to disclose your information to anyone you choose, for any purpose.


Our offices and electronic systems are secure from unauthorized access, and our employees are trained to make certain that the confidentiality of your records is always protected. Our privacy policy and practices apply to all former, current and future patients, so you can be confident that your protected health information will never be improperly disclosed or released.


We will only request personal information needed to provide our standard of quality health care, implement payment activities, conduct normal health practice operations, and comply with the law. This may include your name, address, telephone number(s), Social Security Number, employment data, medical history, health records, etc. While most of the information will be collected from you, we may obtain information from third parties if it is deemed necessary. Regardless of the source, your personal information will always be protected to the full extent of the law.


As stated above, we may disclose information as required by law. We are obligated to provide information to law enforcement and governmental officials under certain circumstances. We will not use your information for marketing purposes without your written consent. We may use and/or disclose your health information to communicate reminders about your appointments including voicemail messages, answering machines, and postcards.


You have a right to request copies of your healthcare information; to request copies in a variety of formats; and to request a list of instances in which we, or our business associates, have disclosed your protected information for uses other than stated above. All such requests must be in writing. We may charge for your copies in an amount allowed by law.


You have the right to request that we place additional restrictions on our use or disclosure of your health information. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in an emergency).


You have the right to request that we place additional restrictions on our use or disclosure of your health information. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in an emergency). You have the right to request that we communicate with you about your health information by alternative means or to alternative locations, and you must make your request in writing. Your request must specify the alternative means or location, and provide satisfactory explanation how payments will be handled under the alternative means or location you request.


You have the right to request that we amend your health information. (Your request must be in writing, and it must explain why the information should be amended.) We may deny your request under certain circumstances.


If you believe your rights have been violated, we urge you to notify us immediately. You can also notify the U.S. Department of Health and Human Services. We thank you for being a patient at our office. Please let us know if you have any questions concerning your privacy rights and the protection of your personal health information.