Financial Information

In-Office Accepted Forms of Payment:

We accept cash, check, debit card, and health savings or flex spending accounts (HSAs/FSAs). We accept all major credit cards with a 4% usage fee. A $25 service charge will be applied to returned checks.

Prepayment Courtesy:

We are happy to offer a 4% courtesy discount for treatment over $150 that is paid in full with cash prior to the reserved time of service.

Payment at Services are Rendered:

Your co-pay is due at the time services are rendered. Your insurance company makes no guarantee of payment; we can only estimate your insurance coverage. For this reason, you may receive a statement with an additional balance after your insurance(s) has met its obligation. We ask that such additional balance be paid at the time of service or within fifteen (15) days of receiving such statement.

Interest-Free Credit Line:

Should you be interested in a payment plan, our office utilizes CareCredit, which is a healthcare credit card. You can charge your balance to CareCredit interest-free for six (6) months for treatment plans. We require that you complete a CareCredit application and be approved for a line of credit at the onset of treatment. Please ask our front desk staff for more information about CareCredit, if interested.

Outstanding Balances and Accounts Past Due (90+ Days):

It is our policy that all outstanding co-pays that insurance has designated as the member’s responsibility need to be paid in full. If the balance on your account is ninety (90) days past due, your account will be deemed delinquent, and a finance charge will be applied to your account and will appear on your statement. Failure to contact our office with regard to a delinquent account will result in said account being turned over to our collections agency. This may adversely affect your credit rating. We provide payment plan options in order to help you avoid collections.

Conscious Oral Sedation or General Anesthesia Appointments:

We require a $200.00 non-refundable deposit for conscious oral sedation or general anesthesia appointments. The deposit will be applied to the total cost of dental services rendered on the day of the procedure. The remaining balance is due in full on the day of treatment.

General Anesthetist:

Our office works with Bay Anesthesia Group. Bay Anesthesia Group requires a separate $300.00 deposit in order to reserve an appointment. This deposit is applied to the total cost of anesthesia. This deposit can be submitted over the phone at (650) 282-4171, or through their website: www.bay-anesthesia.com. The remaining balance is due on the date of service, once the duration of the appointment is confirmed.

Follow-up Dental Care:

No healthcare provider can make guarantees regarding the success of treatment and treatment plans. We strongly encourage you to schedule regular checkup appointments every 3 or 6 months to increase chances of treatment success. Completing purposed treatment, brushing and flossing twice a day, and encouraging a proper diet give your child the best possible opportunity to achieve long-term health.

Canyon Plaza
3417 Broadway Street, #J-1
American Canyon, CA 94503