Thank you for choosing us as your health care provider for your oral and facial surgery needs. We deliver the finest care at the most reasonable cost to our patients, therefore payment is due at the time service is rendered unless other arrangements have been made in advance. The fees in our office are based on the care, skill, time, and judgment necessary to help treat your condition. The fee(s) for your particular treatment will be discussed and a detailed cost estimate shall be provided to you prior to any treatment. If you have any questions regarding fees, insurance network discounts, insurance payments, or out of pocket expenses, please ask our financial coordinator.
The following is a detailed description of our financial policy:
- We reserve the right to collect payment before services are rendered.
- We accept cash, Visa, MasterCard, Discover and American Express.
- We will be happy to assist you with applying for financing, should you so desire, with companies who specialize in healthcare financing for patient treatments. The companies we recommend are listed below:
- Care Credit – http://www.carecredit.com
- Care Credit is a great all-around medical and dental financing company. They have payment plans that are locked in for 60 months at around 11.99% interest. Patients with “OK” credit, this is a good option for you to consider.
- Please remember that you are fully responsible for all fees charged by this office regardless of your insurance coverage.
- Your health insurance coverage is a contract between you and the insurance company. Claims are submitted from this office as a service to patients. In the event that a claim is denied or only a portion is paid, the patient/responsible party is responsible for any balance due.
- Not all services are a covered benefit. Benefits may vary on different insurance plans. Though we assist in the process, it is your responsibility to verify your insurance coverage.
- Fees for non-covered services or out of pocket expenses such as finance charges, deductibles, and co-payments are due at the time of treatment.
- Because insurance policies vary greatly, we can only estimate your coverage and cannot guarantee coverage due to the complexities of insurance contracts.
- Your estimated portion must be paid at the time of service.
- As assistance to our patients, we will bill insurance companies for services rendered and allow them 45 days to remit payment.
- If your insurance company does not pay your claim within 45 days, you are expected to pay the entire balance due.
- If the balance is not paid after 55 days, interest will be automatically charged at a rate of 20% APR.
- Patients may be charged $50.00 for a failed or missed appointment without 24 hours’ notice of cancellation.
- Returned Checks- If a payment by check is denied, a $50 fee will be applied to your account. You may be placed on a cash or credit card only basis if a check is returned.
- Medical Record Copies- charges for copies of your records are:
- Once Insurance payments and adjustments have been accounted for, remaining balances will be billed by mailed invoice with net due in 10 days. Any account balance over 55 days from the day services were rendered and has not had other arrangements made will be subject to enlistment of a third party collection agency and attorney assistance for payment in full.
- $10 – under 20 pages
- $15- 21 – 49 pages
- $20- over 50 pages
- $50- CDs
- Additional fees may apply
- We understand that temporary financial problems may affect timely payment of your balance. We ask that you speak to us if you encounter such problems, so that we may assist you in the management of your account.
We appreciate your trust and the opportunity to serve you. Our patients are very important to us. If you have questions or need assistance regarding your account, our courteous staff is always available to help answer them or provide further clarification.
Complimentary and Discounted Services Policy
No discount or services free of charge will be provided in exchange for any referral or other financial relationship. Additionally, under no circumstances is insurance only payment accepted. If dental insurance benefits are utilized, copayments, coinsurances, and deductibles are expected to be collected.
Applies to any Physician, Dentist, Dental Hygienist, Dental Assistant, Nurse, Medical Assistant, Physician Assistant, Mental Health Provider, Hospital Clinical Employee, Chiropractor, or Optometrist, and their immediate family members, whom practices their respective profession in Bristol, Plainville, Farmington, Thomaston, Waterbury, Burlington, Berlin, or New Britain, CT.
A professional Courtesy discount may include any of the following, or a combination of the following:
Free Sockit Gel wound dressing
Free anesthesia service(s)
Pre-Payment in Full Discount
A 5% discount will be applied to any account that is paid in full in cash, money order, or cashier’s check. Credit card, Care Credit, and personal checks do not qualify. Full payment is based on the offices full fee schedule, or usual and customary fees; not negotiated/discounted insurance fees.
Patients may receive designated surgical services or adjunct healthcare services at no charge based on financial need, or treatment plan complexity at the discretion of Bristol Oral Surgery and Implant Center. Examples of complex treatment plans include orthognathic correction, multiple extractions (> 6 teeth, or 4 or more complete bony impacted teeth), bone grafting procedures, multiple implants, or extensive anesthesia services. Complimentary services will be charged at initial consultation, where applicable, and credited to the account after completion of all planned treatment.
A complimentary service may include any of the following, or a combination of the following:
Examination / Consultation
Surgical Guide / Stent
Deep Sedation / General Anesthesia
Orthognathic diagnostic procedures (photos, models, analysis)
We do not offer any Senior Citizen Discounts.