For your convenience, we accept Visa, MasterCard, Debit, Discover, Care Credit, Cash or Check. We deliver the finest care at the most reasonable cost to our patients, therefore payment is due at the time service is rendered unless other arrangements have been made in advance. If you have questions regarding your account, please contact us at 907 278-5678. Many times, a simple telephone call will clear any misunderstandings.
Please remember you are fully responsible for all fees charged by this office regardless of your insurance coverage.
We will send you a monthly statement. Most insurance companies will respond within four to eight weeks. Please call our office if your statement does not reflect your insurance payment within that time frame. Any remaining balance after your insurance has paid is your responsibility. Your prompt remittance is appreciated. If you are in need of a payment plan, we are proud to offer Care Credit in our office and can give you the information to apply for this easy monthly credit plan prior to your procedure.
We are committed to providing you with the best possible care, and we are pleased to discuss our professional fees with you at any time. Your clear understanding of our Financial Policy is important to our professional relationship. Please ask if you have any questions about fees, the financial policy, or your responsibility involved.
FULL PAYMENT IS DUE AT THE TIME OF SERVICE: Unless prior arrangements have been made with our office staff prior to your appointment, because we have verified your insurance benefits, or the Doctor has agreed to a payment plan for financial hardship..
If you have insurance, we will help you receive maximum benefits as long as you are in compliance with this policy. We require payment in full at the consultation visit. However, we will file your insurance for you so that you can be reimbursed by your insurance company directly. On subsequent visits, we may agree to bill your insurance if you obtain approval from our office staff prior to the date of service. If we do agree to bill your insurance you must pay the amount discussed on the day you are scheduled for services. We commonly referred to this amount as your estimated down payment. You may or may not have a balance once we receive payment from your insurance. If your general dentist or other provider has not submitted any charges you incurred with them for reimbursement, prior to our verification of benefits and estimated downpayment calculation, the amount of your down payment may change, and/or result in a balance owed by you. If your insurance has not paid your claim within 30 days, YOU are responsible to have your account balance paid in full by 45 days from the date of service. However, if you are unable to pay the balance in full contact our office to arrange a payment plan. If you have a credit after insurance pays, a refund check will not be issued to you for at least 60 days. This allows our office time to audit the account for possible overpayment and erroneous payment by your insurance carriers. In some cases it takes up to six months or longer for insurance companies to realize they overpaid. Your account may also show reversals of INCORRECT payments by your Insurance Company. When we do issue a refund, it will never be more than what you paid out-of-pocket. Insurance overpayments will not be refunded to you without a letter of authorization from your insurance company. This must be obtained by you and presented to us for verification. Otherwise, we are happy to collect payment in full at the time of service and have your insurance carrier reimburse you directly.
Your insurance policy is a contract between you and your insurance company. WE CANNOT GUARANTEE CORRECT PAYMENT OF YOUR CLAIM. Neither you, nor we, can assume that your insurance company will accept our charge as a basis for their reimbursement on what they consider an acceptable fee. If your claim is not paid, the insurance company should explain to you why it was rejected. There are some insurance companies that will only reimburse the member directly. If your plan falls under that category you will be required to pay in full for every visit, as insurance would not be paying us. A few examples of insurance companies that reimburse the member directly are; any and all Blue Cross plans and some Delta or Washington Dental plans. If you are unsure whether your plan will reimburse you directly, please ask and we can help you find out. The insurance company looks upon your physician's office as a third, uninvolved party.
WE LOOK TO YOU, NOT THE INSURANCE COMPANY FOR ANY UNPAID BALANCES. YOU ARE RESPONSIBLE FOR THE TIMELY PAYMENT OF YOUR ACCOUNT.
Thank you for understanding and complying with our financial policy; please let us know if you have any questions or concerns.
ALASKA ORAL SURGERY GROUP, P.C. MEDICAID FINANCIAL POLICY
We are committed to providing you with the best possible care and are pleased to discuss any questions you may have financially. Your clear understanding of our Medicaid financial agreement is important to our professional relationship.
Alaska Oral Surgery Group, P.C. accepts all Medicaid patients however; adult Medicaid (ages 21 and over) has an annual benefit limit per year of $1,150. Any services that are not listed as a covered benefit through Medicaid, or services provided after your benefits have been exceed, Alaska Oral Surgery Group, P.C. has the right to bill you, the Medicaid beneficiary. We will verify ahead of time what benefits you, the Medicaid beneficiary have available, send in a pre-authorization prior to any treatment as well as provide you with a detailed treatment plan.
I, __________________________________ understand and agree that if I elect to proceed with treatment that is a non-covered procedure by Medicaid or is performed after I have exceeded my benefit limit, that will be held financially responsible and agree toset up a payment plan for the non-covered services prior to treatment.
Thank you for your understanding of our Medicaid financial policy; please let us know if you have any further questions.