FINANCING INFORMATION

Financial Policy

Thank you for choosing Southern Roots Dental of Louisiana as your dental care provider. We believe that all of our patients deserve the best dental care we can provide. We also believe that everyone benefits when specific financial arrangements are agreed upon. Please understand that payment of your bill is considered as part of your treatment. The following is a statement of our Financial Policy that we require you read and sign prior to any treatment. All patients must complete our information and insurance forms before seeing a doctor.

Regarding Insurance

Your insurance policy is a contract between you and your insurance company. We are not a party in that contract. In the event that we do accept assignment of benefits and your insurance company has not paid your account in full within 60 days, the balance may be transferred to your account. Please be aware that some, and perhaps all, of the services provided may be non-covered services and not considered reasonable and customary under the terms of your insurance policy. Our practice is committed to providing the best treatment for our patients and we charge what is usual and customary for our area. You are responsible for payment regardless of the insurance company’s arbitrary determination of usual and customary rates. Your complete insurance information must be presented at the time of services provided. Insurance claims cannot be backdated. Most benefits will be verified before your insurance company can be billed.

All insurance co-pays and deductibles must be paid at the time of service.

Southern Roots Dental is in network with most insurance providers:

Always Care, Cigna, Vantage, United Healthcare, MetLife, Aetna, Guardian, Delta Dental, Blue Cross Blue Shield. If your Insurance provider is not listed, please call.

Regarding Payment

We accept the following forms of payment: Cash, Check, VISA, Master Card, and American Express. Payment plans: Southern Roots Dental has partnered with Cherry for easy payment options custom to fit your budget. Another partnership with our practice is Care Credit, which offers our patients 0% interest financing for 3, 6, or 12 months with approval.

Payment for services is due at the time services are rendered unless prior arrangements have been made with the doctor or treatment coordinator.

If treatment involves fabrication by a dental laboratory (dentures, crown/bridge, etc.), a 50% deposit will be required at the time of the first impression. The remaining balance is due at the time the prosthesis is cemented or inserted.

The parent that accompanies the minor(s) to the appointment is responsible for any payment due. For unaccompanied minors, non-emergency treatment will not be performed unless charges have been authorized before the appointment time or previous arrangements have been made with the doctor or treatment coordinator.

Checks that are returned to our office from your financial institution are subject to a $20.00 returned check fee. This fee covers the processing fees that are charged to our office.

Financing

Financing is available through CareCredit, Cherry and PRIMA Health Credit:

Plan for Health

If you don’t have dental insurance, we have a solution. We offer a patient loyalty program called Plan for Health that is designed to make dental wellness easy and affordable. By being a member of Plan for Health we are able to reward you for taking responsibility for your oral health.

Billing

All accounts that have not paid the estimated portion of their bill at the time of service will incur a monthly 1.5% finance charge (that equals 18% per annum rate).

Collections

Any account that has not received a payment in 60 days will be handed over to a collection agency that will pursue the responsible party for reimbursement. This will negatively impact your credit history and limit the treatment you can receive at our office.

We would be happy to discuss our charges and how they relate to your particular situation. We also realize that temporary financial situations may affect timely payment of your account. If such problems do arise, we encourage you to contact us promptly for assistance in management of your account.

Thank you for understanding our Financial Policy. Please let us know if you have any questions or concerns.