At your first visit you will need to complete our Health and Dental History Form
. You will be asked to read and sign our Financial Policy
. This form explains to all of our patients the billing process for this office. Please be aware that we are willing to work with our patients in order that all may receive the most appropriate dental treatment. We can offer fair payment options
including a 5% discount for some of the more extensive and costly procedures, that are paid for by cash or check. Also budget plans can be made for completion of treatment plans that require working it into an affordable budget.
Senior Citizen Discount
will include a 5% discount off of any treatment for our patients that are age 65 and over.
FINANCIAL POLICY FOR THE DENTAL OFFICE OF DR. JOHN P. MEYER
This form explains to all of our patients the billing process only of the office -- much like a payment agreement for a credit card, or billing policies and procedures for utility companies. For the answers to any other questions you have, please refer to our Dental Office Information and Policies
brochure and/or ask any of our trained staff members -- we're here to help!
The primary goal of our dental practice
is to provide the highest quality oral health care in the most gentle, efficient and enthusiastic manner. Since our practice is also a business with obligations that must be met, we ask that all patients pay for their treatment in full on the day of each visit to our office unless prior arrangements have been made.
We will do our best
to give you a rough estimate of your investment in your dental health for each upcoming visit, based on your individual treatment plan. You will be given a very close estimate
of your next visit's total bill. Please bring cash, check or credit card at the time of treatment. With a proper diagnosis and a timely treatment plan, most estimates
we provide are accurate.
on your account are discouraged, and must be cleared before the next appointment for any account member or within 30 days of treatment, whichever comes first. Appointments for non-emergency treatment may need to be postponed pending payment of outstanding balances. Amount due and not paid in full within 30 days will be charged interest at a rate of 1.5% per month in addition to a $5.00 monthly billing fee per statement.
over 90 days old will be referred to Trans Union Credit Information Company via Hornell Credit Bureau. All referred accounts are marked "Inactive". In order to have your account "Reactivated", and continue to receive dental treatment in our office, the delinquent balance plus a "Reactivation Fee" of 50% of the delinquent balance referred to the collection agency will be charged to your account. Only after this total account balance has been paid in full can appointments be made and your account and patient status be reactivated.
A returned check fee
of $40.00 will be added to your account for any returned check. Before we accept another payment by check, the $40.00 fee plus full payment for the check that did not clear must be paid in cash, or by VISA, MasterCard, or Discover.
Your dental appointments are scheduled carefully
. Time, trained personnel and dental equipment are reserved for each procedure. Missed appointments add to the cost of dental care when reserved facilities are left waiting empty. We request 48 hours advance notice for rescheduling your appointment. Your account will be charged a broken appointment fee of $35.00 for repeatedly missed appointments without proper notification.