Financial Information
At Dela Rama Dental, our goal is to provide the highest quality dentistry in a caring and comfortable environment. To help avoid any misunderstandings, please review our financial policy below.
Payment Options:
Payment is due at the time services are rendered unless prior arrangements have been made. We accept:
- Cash, debit cards, and major credit cards (Visa, MasterCard, American Express, Discover). Note: If you wish to pay by credit card, a 3% transaction fee will be added to your total balance.
- Health Savings Account (HSA) and Flexible Spending Account (FSA) cards
- Third-party financing through Cherry Financing
- Personal checks
Dental Insurances:
We are currently an in-network provider for Delta Dental PPO insurance at our South San Francisco office. For all other major Preferred Provider Organization (PPO) insurances, we are pleased to accept them as an out-of-network provider.
As a courtesy, we will assist in submitting your insurance claims and do our best to help you receive your full benefits. Please note:
- Your insurance policy is a contract between you and your insurance company.
- Any estimated patient portion is due at the time of service. You are responsible for any balance not covered by your insurance plan.
- If payment is not received from your insurance within 45 days, the balance becomes your responsibility.
Insurance Treatment Estimates:
We provide treatment estimates based on the information provided by your insurance company. These estimates are not a guarantee of payment. Any differences between estimated and actual insurance payments are the patient’s responsibility.
Outstanding Balances:
Balances are due within 30 days of the statement date unless prior arrangements are made. Accounts with unpaid balances over 60 days will be subject to finance charges and if applicable, may be subject to assignment to a third party collection agency.
Missed appointments & Short Notice Cancellations:
To ensure availability for all patients, please provide at least 24-hour notice for cancellations or appointment changes.
Appointments cancelled with less than 24-hour notice (excluding Sundays and holidays) or missed without notice are subject to a cancellation fee of:
- $125 per weekday appointment
- $200 per Saturday appointment
- appointments scheduled for multiple hours may incur additional penalties
Note: If your appointment is scheduled for a Monday and you need to cancel or reschedule, please contact our office by Saturday.
A $35 fee will be applied for any returned checks.
Financial Arrangments:
For extensive treatment plans, customized financial arrangements may be available. Please speak with our front desk team before your appointment to discuss options.
In-House Membership Plan:
We also highly recommend you consider an in house membership plan with our South San Francisco dental office. While it is not dental insurance, it will allow you to receive basic dental care at a discounted rate from our regular prices.
If you have any questions or would like to schedule an appointment, please don't hesitate to reach out to us. We look forward to serving you and helping you achieve a healthy and beautiful smile.
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