THANK YOU for choosing our office for your dental and/or nutritional needs. We are committed to providing the highest quality care available to our patients and to make those services comfortably affordable.
The following is a statement of our Financial Policy which must be reviewed and signed.
As a courtesy, our office will submit your claims to your insurance carrier so you don’t have the burden of filling out the forms necessary to get your reimbursement. Our patients generally receive payment from their insurance carriers within 3-4 weeks. We are out-of-network providers and therefore have no connection to your insurance plan.
If you have any questions about your reimbursement or estimate of benefits
please contact your insurance company directly.
All payments are due when services are rendered!
Cash or Check Payment (discount given)
Visa, Master Card, Discover, Debit
No Interest Payment Plan with Care Credit
Other Options May Be Available for Established Patients
We require at least 24 hours cancellation for all appointments. Our policy is to charge a $50.00 fee for all appointments not re-scheduled or cancelled within this time period. Please help us serve you better by keeping your appointments and being on time. It is not fair to other patients if we do not adhere to this policy because your appointment could have accommodated another patient who was able to be seen that day.
There will be a $35.00 returned check fee charged for any returned checks.
Any account that is unpaid without a payment plan established and timely payments made will be turned over to a collection agency. We strive to work with our patients to provide excellent service. Please pay your bill on time.
Thank you for understanding our Financial Policy.
We are here to assist you in any way possible. Please make your questions and concerns known to our team as our goal
is to ensure that you have an exceptional experience at our office.
I have read the Financial Policy and I understand and agree that:
My insurance is a contract between me and my insurance company. Dr. Buzzatto is not in-network with my insurance company and I authorize payment from my insurance company to be paid directly to me. I understand that NutraDentist is a fee for service dental practice I understand that insurance is not a guarantee of payment.