financial policy

Financial Policy

Our goal is to provide you excellent dental care in a comfortable, personal and cost effective manner. Our financial policies have been developed to help keep the cost of “doing dentistry” down, which means lower fees for you. You can help by paying for your care in a timely manner.

We are a Primary Care Dental Office that offers emergency care to our patients, in addition to daily appointments.

Payment at time of service is expected

Payment to South Denver Dental Group may be made by cash, check, Visa, MasterCard, or American Express. We do our best to include all charges at the time of service. Occasionally, charges might be added to or modified after your visit. For example: If additional X-rays are need for diagnostic purposes.

Insurance Billing

Your insurance policy is a contract between you and your insurance plan. We cannot bill your insurance company unless you give us current and valid insurance information. Insurance billing is a courtesy to our patients whose accounts are in good standing. You are expected to pay your co-payment and for any non-covered services at the time of visit. We expect payment in full within 60 days of services billed to insurance. It is your responsibility to pay any balance older than 60 days and to follow up with your insurance company for reimbursement. If we receive a payment from your insurance company after you balance has been paid, we will issue you a refund or credit to account. It is your responsibility to contact your insurance company if a claim is denied, paid at a lower rate than you expected or if it has not been paid within 60 days. If we have made an error we will gladly resubmit a corrected claim.

All Dental plans are not the same, and they do not always cover the same services. In the event your dental plan determines a service to be “Not covered”, you will be responsible for the complete charge. This office is not responsible for disputing insurance company decisions regarding coverage. Payment is due upon receipt of a statement from our office. We expect that you know your insurance benefits including, but not limited to: deductible and copayment amounts. It is your responsibility to notify our office when your insurance plan or benefits change. Any costs incurred by this office because of incorrect information provided to us by you will be your responsibility. 

Overdue Accounts

We reserve the right to charge a fee for overdue accounts and for submitting insurance forms after 60 days. If you need ongoing dental care, we expect payment on your old balance as well as payment in full of new charges at the time of service. Accounts with balances over 90 days will be turned over to a professional collection agency unless you are making timely payments on an approved payment plan. Once an account has been referred for collection, the Doctor-Patient relationship maybe considered terminated and your records can be referred to a dentist of your choice.

No show and canceled appointments

We reserve the right to charge a fee for “no show” appointments. Please call ahead if you are unable to keep an appointment. 24 hour notice is required. We reserve the right to charge a fee for appointments that are missed or that are canceled with less than 24 hours notice. If two appointments are missed or three appointments are canceled without prior notice patients will be charged for a full cost of missed appointment.

Canceled and Missed Appointment Charges

1st time

2nd time

3rd time

Account Consultation

Dentists, Hygienists, Assistants, and front desk personnel other than the office manager do not discuss financial issues. Only our office manager is authorized to discuss your account and make payment arrangements. They will be happy to help you. In the event you have a problem that can’t be resolved by our office manager, please write a formal letter to Dr. Williams at South Denver Dental Group 850 East Harvard Ave. Suite 375 Denver CO, 80210.

Financial Agreement
  • Not all Services are covered in all insurance contracts. If your insurance plan does not cover a service or procedure, you are responsible for payment of these charges. Please check with your insurance if you have any questions regarding covered services. Our staff has no way to know what procedures and diagnosis might be covered on your plan.
  • While you may have insurance coverage to pay your dental bills, you are ultimately responsible for all charges.
  • I agree to pay promptly all fees and charges for treatments provided to me/or my family.
  • I have read the policies above and understand them.
  • All insurance payments for services rendered are assigned to this office.(a copy of this assignment is as valid as the original)
  • I understand that it is my responsibility to contact my insurance company should a claim be denied or not paid in full.
    • I promise that I will pay all charges in full within 60 days, even if insurance payment is expected.
      • I understand that charges may occasionally be added or modified by my Dentist.
        • I understand that I am financially responsible for all charges, whether or not they are covered by my insurance.
          • I authorize the dental office to release to my insurance carrier any medical information need to obtain payment for services rendered.
            • I understand that if I disagree with any charges, I will contact this office in writing within 10 days of date of the statement.
              • Should legal action be taken by this office to collect an unpaid balance due for dental services provided, I/we agree to pay reasonable attorney’s fees or other such costs as the Court determines proper.