Financial Policy

Thank you for choosing Cudney Oral & Facial Surgery. We are committed to providing the highest quality care at a reasonable cost. In this era of rising healthcare expenses, we make every effort to keep costs down. However, we will not sacrifice quality and patient care to reduce costs. To avoid misunderstandings, we have outlined our financial policy below. A signed financial policy must be on file for each patient prior to being seen in our office.

  • You are responsible for your charges: Patients or their legal guardian are responsible for all charges incurred during treatment and must pay for services at the time of service.
  • Payment for service: Payment is required at the time the service is provided.
  • Payment: We accept checks, Visa, MasterCard, American Express and Discover. We do not offer in-house payment plans. Outside financing is available through Care Credit or Cherry-a healthcare financing program. Terms of no interest plans are anywhere from 6,12,18 or 24 months depending on the amount being financed.
  • Patients with insurance: As a valued service to you, we will submit claims on your behalf to your insurance company. Please do not submit additional claims or information to the insurance company unless we specifically request you to. We are not contracted with any insurance plans, and you will be utilizing out of network benefits. We are unable to submit claims to Caresource, Medicare, Molina, Paramount and any other government funded insurance plans and you will be considered a ‘self-pay’ patient in our office. 
    • Your insurance policy is a contract between you and your insurance company. The doctors are not part of the contract. Therefore, all charges incurred are your responsibility and you are responsible for your charges whether or not your insurance company pays. Insurance payments are supposed to be made within 30 days of filing a claim. However, if your insurance company has not paid within 90 days of your claim, you will need to contact your insurance company to investigate your claim.
    • A pre-treatment estimate can be requested from your insurance company. Most insurance carriers require 4-6 weeks to complete this request, so treatment can be delayed. If you receive additional dental treatment before the scheduled procedure in our office, your estimated remaining benefits could be less or non-existent. Medical insurance carriers will not provide written pre-treatment estimates. Pre-treatment estimates are not a guarantee of payment and the insurance company will determine the final payment amount at the time the claim is processed.
    • In the event your claim must be submitted to medical, we will need a copy of the medical insurance explanation of benefits due to medical insurance not providing out of network providers with this information. It is your responsibility to provide the information needed for the most reimbursement for you. You can email your explanation of benefits to: [email protected].
    • Any reimbursement from your insurance company will be sent to the primary policy holder. In the event that your insurance company sends payment directly to our office, we will reimburse you for the amount paid. Reimbursement will be paid to the person listed as financially responsible on the account.
  • Patients with no insurance: We offer a courtesy discount for patients with no insurance with payment by check . If any claims are submitted on behalf of patient to insurance company, discount is void and patient will owe full fees. Patients who are utilizing Care Credit or Cherry as a healthcare financing option do not qualify for a courtesy discount. Patients who qualify for a bundled treatment plan fee also do not qualify for the courtesy discount.
  • Minor patients: The parent or guardian accompanying a minor is responsible for payment of services. Regardless of insurance coverage, patients age 18 and older are responsible for payment unless a parent accompanies them to the initial appointment and signs this agreement.
  • Divorce situations: The parent who brings the child to the initial appointment and signs the financial policy is responsible for all charges incurred during treatment, regardless of who provides insurance coverage. Our office will not become involved in payment disputes between separated individuals.
  • Returned checks: A $30 service fee will be applied for returned checks.
  • Collection Accounts: Any account that is overdue by 120 days may be submitted to our collection agency. We strive to settle any unpaid accounts prior to this. We will attempt to contact you via all methods you have provided to our office. Please keep your contact details updated with us in the event of any changes.