Dr. Dianne Applegate
Our Policies
Privacy Policy
Our office cares about your dental health and your privacy. We take our legal responsibilities regarding your personal information seriously and follow the Health Information Portability and Accountability Act of 1996 as explained in the link provided.
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HIPAA Notice of Privacy Practices
Financial Policy
We are committed to providing you with the highest quality dental care and up-to-date information so that you may fully participate in and maintain your oral health care needs. Our financial policy is intended to help you understand your options and obligations while helping us to provide you with excellent customer service.
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With the information your insurance company provides us, we will do our best to provide you with an estimate of your co-pay prior to your appointment. The “estimated co-pay” is due at the time of service. We will gladly help you take advantage of your insurance benefits but please remember that all charges are ultimately the responsibility of the patient regardless of insurance coverage.
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We will provide you with an estimated cost of your treatment which is due at the time services are rendered.
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For private pay patients we offer a 3% courtesy discount for full payment with cash or check at the time of service
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Any balances over 30 days old will be subject to a 1.5% monthly finance charge.
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Returned checks for insufficient funds or closed accounts are subject to a $25.00 fee. If a check is returned, cash, credit card, or CareCredit will be the only accepted form of payment.
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Although we are unable to arrange payment plans through our office, we offer a credit program through a third party agency, CareCredit™. CareCredit offers flexible payment plans at low or zero percent interest rates and can be used for a variety of other health care services. You can get more information and apply online at www.carecredit.com or by calling our office.
Payment options:
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Cash/Check
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Debit Card
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Visa/MasterCard
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Discover Card
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CareCredit™
You can view and download a PDF of the Financial Agreement Form here.
Missed appointments, or appointments canceled without 24 hours notice, will incur a $60.00 cancellation fee.
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