Office Policies

Insurance benefits are determined by your employer and not your dentist. Insurance is not a guarantee of payment and will not cover all of your costs. As a courtesy to our patients, we will complete and file insurance forms relative to dental services. Whenever insurance requires a predetermination of benefits prior to treatment being started, we will submit to your insurance company a treatment sequence with charges so that you will be completely aware of your coverage. These amounts are estimates only, and are subject to change based on the type and amount of benefits remaining at the time of service. It is very important that you provide us with a current insurance card at each visit. Insurance benefits are assigned to the practice of Messenger Digital Dentistry.

Our doctors will diagnose treatment based on your dental health and not your insurance coverage. Dental insurance is actually a money benefit, typically provided by an employer, to help their employees pay for routine dental services. Most benefit plans are only designed to cover a portion of the total cost of necessary dental treatment.

Thank you for choosing us as your dental care provider. We are committed to your treatment being successful. Please understand that payment of your bill is considered part of your treatment. The following is a statement of our financial policy which we require that you read and sign prior to any treatment. It is our hope that this policy will facilitate open communication between us and help avoid potential misunderstandings, allowing you to always make the best choices related to your care.

Insurance:

Insurance benefits are determined by your employer and not your dentist. Insurance is not a guarantee of payment and will not cover all of your costs. As a courtesy to our patients, we will complete and file insurance forms relative to dental services. Although we may estimate what your insurance company may pay, it is the insurance company that makes the final determination of your eligibility. You agree to pay any portion of the charges for services rendered, but not covered, by your plan.

Whenever insurance requires a predetermination of benefits prior to treatment being started, we will submit to your insurance company a treatment sequence with charges so that you will be completely aware of your coverage. These amounts are estimates only, and are subject to change based on the type and amount of benefits remaining at the time of service. It is very important that you provide us with a current insurance card at each visit. Insurance benefits are assigned to the practice of Messenger Digital Dentistry however, some insurance companies do not accept assignment of benefit; they pay you, the insured. In those situations, we require payment in full at the time of your appointment.

Required payments: We do not bill for our services. Payment is required at the time you receive your dental treatment. If you have dental insurance, we will estimate your insurance copayments and it must be paid at the time of service.

Payments: Should you end up with a balance on your account we will send you a statement. Unless we approve other arrangements, the balance on your statement is due within 30 days. A finance charge of 1.5% per month will be imposed on any balance not paid within thirty (30) days.

Payment options: For your convenience, we accept cash, check, and all major credit cards. We also offer third party financing through CARE CREDIT and CHERRY. Please ask for more details.

Returned checks: There is a returned check fee of $25.00 for any check returned by our bank. If payment is not received within 21 days of rebilling, your account will be turned over to a collection agency and a fee of 1/3 your delinquent balance will be added to your account.

Past due accounts: If your account becomes past due, and we have to refer your account to a collection agency, you agree to pay a collection fee of 1/3 your delinquent account. I grant my permission to you or your assignee, to telephone me at home or at my work to discuss matters related to this form.

For your convenience, we accept cash, check, and all major credit cards. We also offer Cherry, CareCredit® and LENDINGCLUB®, which are financing options that are available.

This policy was created to ultimately help us serve all patients better. We are very pleased to participate in your dental health care, and have set aside time for your appointment. It is very important to keep all scheduled appointments because your treatment and oral health may be affected by any missed appointments however; we understand that sometimes it is necessary to cancel or change an appointment. If you must cancel or reschedule an appointment, we would greatly appreciate that you notify us at least 48 business hours prior to your scheduled appointment time. Broken and missed appointments, as well as late arrivals create scheduling problems for other patients as well as the practice.

If you miss an appointment without contacting our office within the required time, this is considered a missed appointment. A fee of $50.00 will be charged to you; this fee cannot be billed to your insurance company and will be your direct responsibility. Additionally, if a patient is more than 10 minutes late without prior notice, we will consider this a missed appointment and the $50.00 cancellation fee will be charged. No future appointments can be scheduled without the payment of this fee.

Multiple missed appointments can result in dismissal from our practice. Every patient is very important to our practice and in order to keep the schedule flowing, advance notice of cancellations help tremendously. We do realize that there are some circumstances that occur that make it impossible for you to contact us. Any extenuating circumstance will be considered by Dr. Gene Messenger

Your Information. Your Rights. Our Responsibilities. This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please click the button below to review our HIPAA Policy.