Welcome and
thank you for choosing Lantzy Children's
Dentistry for your dental health concerns.
We are committed to providing you with the
highest quality dental care in an efficient,
timely, and cost effective manner. We hope
that by providing you with our policies in
advance, we can prevent any
misunderstandings or frustration at the
time of your visit. Appointments
Check - In: Please arrive
for your appointment a few minutes early so
that all paperwork may be completed before
you see the dentist. Please bring your
current insurance card with you to each
visit. On follow-up visits, you will be
asked to verify demographic/insurance
information so that our records remain up
to-date.
Check - Out: Please be prepared to
pay for the current visit as well as any
past balances on your account. Payment of
co-pays, deductible, supplies or any
non-covered services will be required at the
time of service. Estimated patient
responsibilities for surgical procedures and
office care will be determined by insurance
estimates. We accept CASH, CHECKS,
MASTERCARD, VISA, DISCOVER, AMERICAN
EXPRESS, and
CARE CREDIT.
Late Arrivals: If you
arrive more than 10 minutes past your
appointment time, you may be rescheduled so
that other patients are not inconvenienced.
No-Shows and Late Cancellations: We require
an hour notice if you must cancel your
appointment. If you cancel the same day as
your appointment, this will be considered a
missed appointment. AFTER THREE MISSED OR
CANCELLED APPOINTMENTS WITH LESS THAN 48
HOURS NOTICE YOU WILL BE DISMISSED FROM THE
OFFICE.
Minors: The parents/guardians
accompanying a minor are responsible for
providing current insurance information for
the minor and/or payment in full for
services provided. Unaccompanied minors must
have a written authorization for dental
treatment signed by the parent or guardian
before treatment can be rendered.
Insurance
When making
an appointment with our office, it is your
responsibility to confirm with your
insurance company that the dentist is
currently under contract with your plan. If
your plan requires that you have a referral
prior to seeing a specialist, please contact
your primary dentist so that you have the
referral in hand at the time of your
appointment. We do accept faxed referrals;
however, we advise you to call prior to your
appointment time to be sure we have your
referral. If we do not have a referral at
your appointment time, we will need to
reschedule your visit, unless you choose to
be seen without using your insurance
benefits and pay for your visit in full. If
your insurance should happen to change, we
require that you notify our office 48 hours
prior to your appointment time.
The
responsible party is responsible for knowing
their benefit coverage for specialist
visits. We gladly file your insurance claim
on your bebalf. We allow 45 days from the
date the claim is filed for the insurance
company to pay. If your carrier does not pay
within this time, you could be responsible
for the entire balance. We will not become
involved in disputes between you and your
insurance company regarding coverage and/or
policy benefit criteria, i.e. deductible,
non-covered services, co-insurance,
coordination of benefits, preexisting
conditions or reasonable and customary
charges, etc, other than to supply factual
information when necessary.
You are
responsible for deductible, co-insurance,
non-covered services, and any other charges
your insurance may not cover. You will be
sent statements on a monthly basis regarding
any monies owed by you, the patient. If the
same balance becomes more than 3 months past
due you will then be charge a finance charge
of $10.00 each month thereafter until tbe
balance is paid in full. In the event your
account is turned over to a collection
agency, all fees associated with the
collection of your account will be added to
your balance when reporting to the
collection firm.
Our office is no
longer accepting DMO policies as of January
1, 2010. Please contact our office to assist
you with any questions you may have
regarding other insurance or payment options
or care credit opportunities.
For your
convenience, we file with all insurance
companies. Following is a list of insurance
companies that we are in network with:
Aetna, Ameritas, Assurant, BCBS, Cigna,
Delta Dental, Guardian, Humana/Comp
Benefits, Metlife, Principal, Safeguard, and
United Concordia. Medicaid accepted at both locations.
PPO
plans do not have any age restrictions or
require any referrals to see a pediatric
dentist.
Delta Dental:
Premier, always accepted. PPO, accepted, but
we do not know how much is covered because
of the possible difference in fee schedule.
For our Roanoke office:
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For our Decatur office:
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