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Cancellation Policy

It is our pleasure to serve you here at Advanced Cosmetic and Implant Dentistry of Maryland. We understand for the great percentage of patients this form is not really relevant as they keep their appointments. However, chronic no shows and last minute cancellations have forced us to either raise our rates or implement a strict cancellation policy. In order that we might not raise our rates and thus penalize the majority of reliable patients we have chosen to implement a strict cancellation policy.

• The initial (or first) appointment scheduled requires a REFUNDABLE $40 deposit to reserve the time.

• All appointments for doctor treatment (fillings, crowns, etc) may require a refundable deposit of $100 or more depending on the nature and length of the appointment.

• Appointments for future cleanings generally do not require a deposit unless there is a pattern of last minute cancellations or no shows.

If you arrive at your appointment as planned the deposit will be credited to your account (if you have a balance). This can also be refunded if requested (if you do not have a balance). If you need to cancel or switch your appointment time we require 48 hours “working day” notice.
All patients who do not show, show up later than 10 minutes after their assigned appointment, or cancel outside of our required 48 hour notice will forfeit their deposit and/or will be charged a $80 cancellation fee ($80 total fee).
Please note this policy is unique because it includes any reason for the absence: work meeting, out sick, kids sick, Ravens game, sunny outside (we have heard some creative ones!). Because our previous policies were continually taken advantage of we have had to enforce this consistently.
I understand the cancellation policy at Advanced Cosmetic and Implant Dentistry of Maryland and agree to the terms.

Financial policy insurance

Because we understand that dental insurance plays a role in helping many people defray some of the costs of dental care, we would like to share with you the following facts about dental insurance.
Dental insurance is not meant to be a pay‐all…. It is meant to only assist in this process. Dental insurance plans do not necessarily correspond to your patient needs. As such, many routine and necessary dental services are not covered, even though you may need those services. Our responsibility is to provide you with the best treatment to meet your needs, not to try to match your care to any specific insurance plan limitations.
For example, often insurance companies only pay for the price of silver, amalgam fillings. We only place white, composite fillings here. Thus, if this is your case, you will be required to pay the difference. This is but one example of insurance differences and listing them all would be impossible. Bottom line is we do our best guesses of what you will have covered but we are often wrong, even though this is never our intent. And you are responsible for whatever portion your insurance does not cover.
Another issue patients need to consider is “in network” or “out of network” coverage from their insurance carriers. Sometimes we are “in” a patient’s network, sometimes we are not, and sometimes it doesn’t matter. It is your responsibility to know which you are a part of should you elect care. This may or may not correspond to how much you pay out of pocket for the care.
Please understand that we cannot accept responsibility for collecting an insurance claim, or for negotiating disputed claims and that you are responsible for anything your insurance company does not cover.

At time of service payment options

We offer the following financial options:
  1. VISA/ MASTERCARD/ AMEX/Cash/Check
  2. Patients with Insurance ‐ a partial payment is required at the start of all treatment beyond routine cleaning
    and exams. This includes 25% of the total for fillings or 50% of the total for crowns. A statement will be
    sent AFTER we receive the insurance payment‐ if no payment or a partial payment is received the
    remaining balance will need to be paid by the patient within 30 days of appointment.
  3. Care Credit Patient Financing These are our in‐house financing options and are great for larger cases when a patient is unable to pay upfront. WE ACCEPT Both! Ask for details. 

Please initial the following

  • A finance charge of 1% per month (with a minimum rebilling fee of $5.00) is applied to all account balance after 90 days.
  • For all NSF (returned) checks there will be a fee of $35.00 and a late charge assessed.
  • For all NSF (returned) checks there will be a fee of $35.00 and a late charge assessed.
I understand that the quotes regarding what my insurance may pay from Advanced Cosmetic and Implant Dentistry of Maryland are best guesses and are not definitive. Often you will be required to pay more than what we estimate, even though this is never our intent. 

Financial policy no insurance

No given format file in the original website