Dental Financial Agreement Policy Arlington Heights
We are committed to providing our patients with the highest quality care possible.
This is a summary of our financial policy at Westgate Dental Care, which we require patients to read, agree to, and sign (our Financial Policy Form) before any treatment. Payment is due at the time service is provided. Our Arlington Heights dental office accepts cash, personal checks, credit cards, and outside patient financing.
Dental Appointment Policy
A 50% deposit must be paid to schedule your treatment. Your deposit will be applied toward your patient portion and the remaining 50% will be collected at the time services are rendered.
We accept cash, personal checks, Flexible Spending Accounts, Health Savings Accounts, and debit cards.
We accept all major credit cards, however, a 3% surcharge will apply. This 3% surcharge is not greater than our total cost of accepting credit cards.
We offer CareCredit, Sunbit, and Proceed Finance for those requiring monthly payment plans. Please let us know if you would like more information about financing options.
When we schedule your appointment, this time is reserved exclusively for you. When you fail to notify us of your inability to keep the appointment, another patient in need of dentistry is unable to receive treatment. We request that you give us 48 hours' notice when you realize you cannot keep an appointment. A cancellation fee of $50 per hour of scheduled appointment time will be assessed for appointments broken with less than 48 hours’ notice.
We thank you for the opportunity to serve your dental health care needs and welcome any questions you may have concerning your care or our financial policy.
Do You Have Dental Insurance?
We must emphasize that as your dental care provider, our relationship is with you, our patient, not with your insurance company. Your insurance policy is a contract between you, your employer, and your insurance company.
As a courtesy to you, we will help you process all your insurance claims. Please understand that we will provide an insurance estimate to you, however, it is not a guarantee that your insurance will pay exactly as estimated. Your insurance company and your plan benefits will determine the amount paid. We will, of course, do all we can to make sure your estimate is as accurate as possible.
If your insurance company has not made payment within 60 days, we will ask that you contact your insurance company to make sure payment is expected. If payment is not received or your claim is denied, you will be responsible for paying the full amount at that time.
We ask you to sign our Financial Policy form and/or any other necessary documents that may be required by your insurance company. This form will instruct your insurance company to make payment directly to our office.
We ask that you pay the deductible and co-payment, which is the estimated amount, not covered by your insurance company, by cash, check, credit card, or patient financing at the time we provide the service to you.
We will cooperate fully with the regulations and requests of your insurance company that may assist in the claim being paid. Our office will not, however, enter into a dispute with your insurance company over any claim.
We work with the following PPO’s, effective as of June 2024:
- Aetna
- Aetna Medicare
- Ameritas
- Blue Cross Blue Shield (not all plans – please contact us to learn more)
- Connection Dental / GEHA
- Cigna
- DHA/Sunlife
- Guardian
- Humana
- Humana Medicare
- Lincoln Financial
- MetLife
- Principal
- UC Commercial
- United Healthcare
- UHC Medicare
