1. For patients with insurance: We will verify insurance benefits before your initial appointment whenever possible. Any amounts which we estimate are not covered by insurance will be collected at the time of service. As a courtesy to our patients with insurance, we will bill up to two insurance policies for you. Any additional policies will need to be self-billed.
2. For patients without insurance: We collect in full at the time of service. Our office offers a 5% discount for patients without insurance who pay for their treatment in full with cash or check only. Debit cards are not considered cash payment. We charge $25.00 fee for any checks returned NSF.
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4. Insurance companies use the term “usual and customary” when setting fee limitations on services. The term suggests, but does not necessarily reflect, the average fees charged by doctors in our area. Please be aware that some insurance companies pay claims based on their fee schedules and not those of our office. You will be responsible for any difference between your insurance company’s “usual and customary” fees and those of our office.
5. We are not a participating or preferred provider for any insurance company. We are considered an out of network provider. However, our fees are approved by ODS Dental. We are not a Medicare provider and do not accept OHP, COIHS, or TriCare Insurance in our office.
6. We require prior authorization for all Hospital Surgeries, TMJ Splints, and Sleep Apnea Appliances. Regardless of insurance coverage, a 50% deposit is required at the Pre-surgery appointment for all hospital and surgery center surgeries. For TMJ Splints and Sleep Apnea Appliances, we collect your portion in full at the time of the Impression Appointment. Any hospital, surgery center, lab, and anesthesiologist charges are separate from our office.
7. If any balance due and owing is not paid within thirty (30) days from the date of invoice, the patient shall be charged interest at the rate of 18% per annum. If this agreement or any invoice is placed in the hands of an attorney for collection, the patient promises and agrees to pay to Keith E. Krueger, DMD, PC its reasonable attorney fees and collection costs even if no suit or action is filed. If suit or action is filed, the patient agrees to pay Keith E. Krueger, DMD, PC any and all such reasonable attorney fees as shall be affixed by an arbitrator or courts in which the suit or action, including any appeals are arbitrated, heard or decided.
Please remember you are fully responsible for all fees charged by this office regardless of your insurance coverage.