1310 Atlanta Highway
Auburn, GA 30011

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William Herr, DDS

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Our Financial Policy

Thank you for choosing Auburn Dental Center for your family’s dental needs.   We are committed to providing you with affordable and excellent dental care.  Your trust is very important to us so our goal is to make sure you fully understand your treatment needs and financial responsibility before treatment begins.  We will make every effort to work with you to ensure that your dental needs can be met.

 

PAYMENTS:

Payment is expected at the time of service unless prior financial arrangements have been made.  We offer several options:               

  1. Cash Discounts:
    1. 5% discount for cash, credit card or check payment when the case is paid in full prior to start of treatment.  Up to 10% discount if case is over certain range (see staff for details), 65 and older or military veterans.
    2. Any check that is returned for any reason will be charged a $40.00 fee.  Furthermore, the patient will not be able to write another check until the full fee (original portion plus the fee) is paid. If a check bounces the second time, the same policy applies again and he/she will no longer have the privilege of paying by check again.
  2. We accept Visa, Mastercard, and Discover.
  3. Patients with insurance:  co-pays, deductibles, and/or portion not covered by insurance are due at the time of treatment.
  4. Patients without insurance:  all payments for dental services rendered are due at the time of service.  Please refer to Cash Discounts above and/or talk to our financial coordinator for any discounts that you may qualify for.

 

PATIENTS WITH DENTAL INSURANCE

Our friendly staff will be happy to help you maximize dental benefits.  We can help you verify your dental insurance coverage and benefits prior to you arriving at the office.  Therefore, please fill out all necessary insurance informationonline prior to your first visit.  That way, we’ll be able to save you time and give you a closer estimate on your portion of the fee for each visit.  Most plans only cover part of your dental service which means that you are responsible for any part that’s not cover and/or any deductible.  Many dental insurance policies have exclusions and limitations that can affect your out-of-pocket cost. 

 

As a courtesy to our insured patients, we will be happy to help file your dental insurance claims. However, please remember that your dental insurance policy is a contract between you, your employer and the insurance company.  Although we agree to charge our fees to you based on your insurance fee schedule and help you file the claim, we are not a party to your insurance contract.  Therefore, any payment that is not received from your insurance after 60 days from the treatment day will be due in full from you.  You will then have to obtain reimbursement directly from your insurance company.  Please understand that we cannot accept responsibility for collecting your insurance claim or for negotiating disputed claims between you and your insurance company.  There will be a finance charge of 1.5% per month applied on all account balances after 90 days. 

 

There will be a minimum 1/3 down payment required at the time of service for any dental procedure that requires the service of a laboratory (crowns, bridges, dentures, etc.). 

 

MISSED APPOINTMENTS

We, here at Auburn Dental Center, are truly blessed with wonderful patients.  We fully understand that life can be unpredictable and many times things come up unexpectedly.  However, please understand that your appointment time is reserved especially just for you, and we truly do look forward to helping you with your dental needs. When life does take an unexpected turn and you cannot make it to your dental appointment, we respectfully request that you notify us at least 24 hours ahead.    If you missed the first appointment without notifying us, we will kindly ask that you not do that again.  The second time you miss your appointment, we reserve the right to charge to your account a missed appointment fee of $45 dollars.  You will have to pay the fee prior to making another dental appointment with us.  If you missed the third time without notifying us, you will be put on a walk-in status only or we may decide to terminate our relationship with you and ask that you seek dental services somewhere else.  You will be allowed to get emergency dental services for the next 30 days while you look for a new dental home.  We thank you ahead for your cooperation and hope that we will never have to implement this policy. 

 

Please read the information above carefully and let us know if you have any questions regarding our financial agreement. 

 

I have read and understand the above financial agreement.  Any questions and concerns were answered fully to my satisfaction.  I understand that I am responsible for all fees and/or balances due and agree to pay them in a timely manner in order to avoid any additional charges.  I, the undersigned (patient or legally responsible party) hereby authorize treatment to be rendered and assume all financial responsibilities.  Furthermore, I authorize release of any information relating to my insurance claims and the assignment of any and all dental benefits paid directly to Herr Dental Associates, LLC DBA Auburn Dental Center of the group insurance benefits otherwise payable to me and my credit information may be accessed when necessary.  I understand that I am responsible for all costs of dental treatment and any additional costs incurred in collecting this account, including interests, court cost and attorney fees, will be added to my balance. 

 

Questions or Comments?
We encourage you to contact us whenever you have an interest or concern about our services.

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