Payment Options

Flexible

Payment Options

We make it easy for you to get the care you need.

Sunbit Pay-Over-Time

Clear, transparent payment options

To help you Smile Now and Pay-over-time, we now offer access to flexible payment plans for your dental needs. Just click the button below to check out your financing options.

Major Insurance Plans Accepted

We accept most major dental insurance, Medicaid and some discount plans.  Click here for more information on accepted plans.

Credit Cards Accepted

We accept major credit cards.

Cash Always Accepted

Yes, cash is always welcome.  No personal checks please.


Our Financial Policy


Thank you for choosing Cottonwood Park Dentistry for your dental health care. Your clear understanding of this Financial Policy is important to our professional relationship. If you have any questions about our fees, our policies or your financial responsibilities, please do not hesitate to contact us. Please take time to carefully review the following information and acknowledge your understanding of it by signing below.


We require that all patients review and acknowledge our Financial Policy prior to seeing the doctor or hygienist and upon each annual visit thereafter. It is your responsibility to notify our office of any patient information changes (i.e., address, name, insurance information, etc.).


SELF-PAY PATIENTS: This category includes patients with no insurance and patients who have an insurance plan with which we do not participate. Payment for dental services is required at the time of service and will be collected at check-in or check-out. We accept most major credit cards, checks and cash. We will always provide you with a receipt. We also accept Care Credit and Wells Fargo Health Advantage (please contact our office for additional information on these payment programs).


INSURANCE: We participate in most insurance plans, including Medicaid.


  • It is the patient’s responsibility to provide our office with current insurance information. We will ask for your insurance card at your first visit and will copy for our records. Please be prepared to show your current insurance card at each appointment.
  • If current information is not obtained at the time of service, it will become the patient’s responsibility to pay the entire balance until current information is provided to our office.
  • Your insurance policy is a contract between you and your insurance company. As a courtesy, and pursuant to contractual obligations, we submit all your claims for you. However, we will not become involved in disputes between you and your insurance carrier. This includes, but is not limited to, deductibles, co-payments, non-covered charges and “usual and customary” charges. We will supply information as necessary.
  • If your insurance company does not pay your claim within 45 days, the balance will automatically be billed to you.
  • You are ultimately responsible for the timely payment of your account.


CO-PAYS: Co-payments are due at the time of service and will be collected at check-out.


DEDUCTIBLES, CO-INSURANCE and ESTIMATES for in-office procedures:


  • Any balance related to unmet deductibles and estimation of co-insurance, as per the contract you have with your insurance, is to be paid at the time of service.
  • For in-office treatment, an estimation of patient responsibility will be provided to you and is to be paid in full at the time of service (except for orthodontic payment plans).
  • Additional balances due, if applicable, will be billed to you after the insurance carrier has processed the claim.


UNPAID/OUTSTANDING BALANCES:


  • We ask that full payment be made at the time of service unless prior arrangements (for example, orthodontic payment plan) have been made through our office.
  • If your insurance company has not paid the balance in full, you will receive a statement notifying you of the amount due.
  • You may call us to discuss payment arrangements if necessary. Otherwise overdue balances will be considered for further collection activity.
  • Should your account become delinquent and 90 days past due, we may refer the outstanding balance to a third-party collection agency, and you agree to reimburse us the fees of such agency (typically 30% of the referred balance) and any and all other costs, including reasonable attorneys’ fees, incurred in the collection of the outstanding balance.
  • Failure to pay on a timely basis may result in you being discharged from this practice. If this is to occur, you will be notified by regular and certified mail that you have 30 days to find alternative dental care. During that 30-day period, our provider staff will only be able to treat you on an emergency basis.


RETURNED PAYMENT (NSF): The charge for a returned check or rejection of bank draft is $35 and is payable by cash or credit card (no checks accepted payment of NSF fees). This amount will be applied to your account in addition to the insufficient funds amount.


MISSED APPOINTMENTS: Please help us serve you better by keeping scheduled appointments. In the event you are unable to keep your appointment, we request, at minimum, a 24-hour notice. Failure to provide notice may result in a $25 missed appointment charge. This charge is the responsibility of the patient and is not covered by any insurance carrier.


CREDIT BALANCES: From time to time, you may accrue a credit balance on your account. If your account reflects a credit balance, our policy is to carry the balance on the account until your next appointment or your transfer from the organization. You may request a refund of a credit balance at any time. Please allow ample time for review of your account and processing through our accounting department.


If you have any questions regarding this Financial Policy, please ask or call BEFORE you are seen by the doctor or hygienist.


Thank you again for trusting us with your dental health care.


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