Rabon Family Dentistry Policies
Payment should be made at the time the dental services are rendered. However, as a courtesy to our patients, we are happy to file insurance forms relative to dental treatment. We do not charge to file your forms. We will also work with our patients to help resolve any conflicts with insurance companies over payment. You will be asked to pay a percentage of the total amount owed at your visit unless we are sure insurance will cover the entire amount.
For all crowns, bridges, and partial dentures, a deposit of one half needs to be paid when the case is started and impressions are made. Our laboratories require payment from our office when their services are provided. The remainder of the cost is to be paid on delivery of the appliance. This policy may vary due to the type of insurance that you have.
Special Financial Considerations:
If you need other payment arrangements, these must be made
in our office before treatment is begun. These alternate arrangements must be done at our office and not over the telephone or internet. This is because we have a payment plan form that must be signed by you after terms are agreed upon.
All emergency visits and emergency extractions are to be paid for when they are done. You may pay for these with cash or credit cards for Visa and Master Charge.
We work by appointments. Our office respects your time by making every effort to stay on schedule. Please be as considerate of our team's time as well. If you cannot keep an appointment, we ask that you give us at least a 24 hour notice. Last minute or cancellations the day of the appointment are also considered broken appointments. Adequate notice that you cannot make an appointment allows us to take care of someone else who is needing treatment. Of course, we understand that unforeseeable circumstances do arise. Thank you so much for your consideration in this matter.
We are a Delta Dental Insurance Company provider.
If for some reason, your insurance fails to pay, you are responsible for the amount owed for services rendered to you. We file insurance as a courtesy to our patients but the patient is ultimately responsible for payment.
(Please print, fill out and bring all required forms with you to your appointment)
Patient Registration Form
Cash, Visa and Master Charge