Financial Guidelines

Appointments – We ask that if an appointment must be cancelled you give us at least 24 hours notice. Missed appointments and same day cancellations will be assessed a $50.00 fee. We understand unexpected issues may arise, however, the more notice given the better we can care for our patients.

Assignment of Benefits – The practice will accept assignment of benefits IF all of the pertinent information is provided prior to the appointment and the insurance company will accept assignment to the dentist.

Self-Pay Patients – Payment in full is required at the time services are rendered.

Patients with Insurance – Your insurance is a contract between you and your insurance company. IT IS YOUR RESPONSIBILITY TO KNOW YOUR OWN COVERAGE. As a courtesy, we will file your claims. The patient pays the estimated portion (as calculated by the practice) at the time of the service. Any estimate given to you by the practice is purely an estimate. The insurance companies do not guarantee any payment until they receive the claim, review it, and process it according to the specific plan allowable, deductibles and co-pays. If there is a balance after the claim is filed and insurance payment is received, a bill will be generated and sent to the patient for immediate payment. If the claim has not been paid in 45 days, we require you pay the balance using one of the approved payment methods.

Maryland Healthy Smiles (Medicaid) – It is your responsibility to confirm your eligibility. If at the time of service you are not eligible for benefits you will be responsible for all charges.
The office will allow 2 no show or late cancellations; after that we will provide emergency care only for 30 days to allow you time to find a new dentist.

 

Payment Methods – We accept Cash, Electronic Funds Transfer through checking or saving accounts, Visa, Master Card, Discover and American Express. The name OCA and/or OrthoSynetics, Inc. will appear on your bank statement instead of Pediatric Dental Center of Frederick. All non-sufficient funds transfers are subject to a returned item fee of $25.00.

Balances - We have retained an outside management company, OrthoSynetics, Inc. to handle the follow up on all of our insurance claims and patient balances. Should you have any questions in reference to your account or statement, please call OrthoSynetics Dental Financial Services at (800) 779-0126 for clarification. Any account that still has a balance once it is 30 days old will receive a follow up call from an account manager at OrthoSynetics.



● OrthoSynetics’ account managers are able to process check and credit card payments over the phone to assist you in clearing up any balance you may have and can be reached at (800) 779-0126.



● Once attempts have been made by phone and there is no response to the courtesy calls, the account manager will send out a “15 day to pay” letter.

● If we do not receive a response to the “15 day to pay” letter, then the account will be sent to a 3rd party collections agency.  You will be responsible for any costs incurred to collect including but not limited to, collection agency fees, attorney fees and court costs.

Find us: 7360 Guilford Drive, Suite 102  Frederick, MD  21704

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© 2019 Michael Dutzer and the Pediatric Dental Center of Frederick