Office Finance Policies Williamsville & Niagara
We, the staff of Niagara Dental Implant & Oral Surgery, thank you for choosing us as your dental/health provider. We consider it a privilege to serve your needs and we look forward to doing so. We are committed to provide you with the highest level of care and to build a successful provider-patient relationship with you and your family. We believe your understanding of our patients’ financial responsibility is vital to the provider-patient relationship and our goal is to not only inform you of the provisional aspects of that financial policy but also to keep the lines of communication open regarding them. We believe this level of communication and cooperation will allow us to continue to provide quality service to all of our valued patients.
Please understand that payment for services is an important part of the provider-patient relationship. If you do not have a dental benefit plan or participate in a plan that will not honor an assignment of dental benefits, payment for services will be due at the time of service. Dr. Nigalye and his staff are committed to providing excellent care and guide patients in choosing the best payment option for their individual needs. We make payment as convenient as possible by accepting cash, check, Visa, MasterCard, Discover, Amex and CareCredit. A service fee will be assessed for all returned checks.
Achieving a high quality result is our most important consideration for our patients. Please remember that your dental benefit plan is a contract between you and your dental carrier. We will as a courtesy, bill your dental benefit plan and help you receive the maximum allowable benefit under your policy. This may include us billing your medical and dental benefit plans. It is your responsibility to provide us with all necessary benefit eligibility, identification, authorization and referral information and to notify our office of any changes when/if they occur. It is the patients responsibility to know if our office is participating or non-participating with their benefit plan. Failure to provide all required information may necessitate patient payment for all charges. When benefits are involved, we are contractually obligated to collect co-payments, co-insurance, and deductibles, as outlined by your benefit carrier.
Please be aware that out-of-network benefit carriers often prohibit assignment of benefits and may try to limit their financial liability with arbitrary limits, exclusions, or reductions such as reasonable and customary or usual and prevailing reductions. Our fees are well within such ranges and although we will assist in the filing of an appeal if these limitations are imposed, you as the guarantor are responsible for all out-of-network fees. If we are not contracted with your carrier we will not negotiate reduced fees with your carrier.
Our office will do everything possible to help you understand and make the most of your benefits. Please remember that you are ultimately responsible for all expenses incurred. Once we receive payment from your dental/medical benefit plan, we will notify you by mail if there is a balance. After your dental/medical benefit plan has paid its portion, a statement is sent to the mailing address on record , for the remaining balance. Payment is expected within 10 business days of the statement date. On or around the 10th business day an attempt will be made to reach you by phone and if no contact is made, the credit card on file will be charged the remaining balance. For patients that are unwilling to keep credit card authorization on file with our office the total estimated fee through the dental benefit plan is due at the time of service. Balances older than sixty days may be subject to late charges, collection fees and/or reasonable attorney fees and costs. If you have any questions regarding the above information, please do not hesitate to ask us.
You assign any dental benefits to which you may be entitled to Niagara Dental Implant & Oral Surgery. If there is a denial of coverage by your dental benefit plan, you designate Niagara Dental Implant & Oral Surgery or its representative to appeal or otherwise pursue coverage, and/or communicate directly with your dental benefit plan regarding coverage, on their behalf and yours.