Important Financial Information

All orthodontic services performed in this office are charged directly to the patient or responsible party. Services are not rendered on the assumption that our fee will be paid by your insurance company. As a courtesy, we will assist you in completing insurance claim forms for the orthodontic treatment.

The treatment fee includes beginning, progress, and final x-rays, and one set of retainers. The treatment fee does not include any services provided by any practice outside of Dr. Pearson's orthodontic practice. This includes, but is not limited to, regular dental cleanings, restorations (filings/crowns or cosmetic dentistry), extractions or other surgery, gum fiber releases, or TMJ therapy. Retainer repair, replacement, or additional appliances may result in additional fees.

The estimated treatment time is based on professional experience and assumes complete patient/parent cooperation. Should active treatment extend beyond the estimated treatment time because of poor cooperation or an unexpected change in the treatment plan occurs, additional fees may apply.

If a patient relocates to another area, requiring treatment to be completed by another orthodontic practice, our total fee will be adjusted to reflect services provided.

Full Payment

As a courtesy to patients who pay their account balance in full at the start of treatment, Dr. Pearson offers a 5% discount.

Insurance

Orthodontic insurance differs from dental insurance in that each insured individual usually has a lifetime maximum benefit for orthodontic services. This benefit is typically paid as a percentage (50% - 80%) of the orthodontic fee until the maximum has been reached.

There are many different agreements between insurance carriers (XYZ Insurance Co.) and their subscribers (your employer). Check with your human resources department of your carrier if you have questions.

Here’s how our office works to assist you with your insurance:

• We verify that you have orthodontic benefits.
• We generate an insurance form that describes the orthodontic problems, the required treatment, the length of treatment time and the financial arrangements. We will submit this form to your insurance carrier for reimbursement of your orthodontic fees. That’s the “doctor” part. You must provide specific personal and carrier information and your signature is required to allow us to release medical information to your carrier. That’s the “insured’s” part.
• For your convenience, we accept payments from your insurance company assigned to us by you, the insured. If the total paid by your carrier is less than originally estimated, you are responsible for any balance that your carrier does not pay. Your monthly payment arrangements will be restructured to reflect the difference.

We are happy to work together with you and your insurance company to make sure that you receive the maximum benefit possible under your individual policy. However, please be aware that you, the insured, have far more clout in resolving insurance issues than we do.

Other Considerations

Changing carriers while in treatment, either because you change employers or your employer changes the carrier/insurance policy, may change your benefits.

Having two policies (primary and secondary) may not double your fun or your benefits. Some secondary insurances have a clause prohibiting duplication of benefits.

Payment Plans

There is no interest or finance charge associated with in-office financing, provided that the schedule of payments is kept current. Monthly payments are due on or before the tenth of the month, and become delinquent the 20th of the month. A $15.00 late payment fee may be charged. Returned Check charge: $15.00.

Monthly installments represent a convenient method of payment and are not based on the number of appointments per, year, or length of treatment. Actual treatment time may be shorter or longer than the payment period. The balance of the fee is due at the time appliances are removed.