Dr. F.D. Ramirez, D.D.S

7052 Dublin Blvd., Dublin, CA 94568
Tel: 925-556-9994 | Fax: 556-6710
email | directions

New Patients > Financial Policy

You must read, understand, and agree to our Financial Policy before being seen in our office.

When you are in the midst of being treated for a medical or dental problem, it's easy to forget that a doctor's office is also a business. We understand that. Yet, we also want our patients to understand that an important part of any business is also collecting payment for the service it provides. In the interest of both good medicine and good business, we have established a policy to avoid any misunderstanding.

Registration Forms

All Registration Forms must be completed and signed prior to seeing the dentist.

Fees

We do our best to inform each patient exactly what the fees for their dental work will be. After the doctor has determined what work is needed, a financial coordinator will go over your treatment plan in detail with you. We do our best to estimate how much your insurance will pay and we thoroughly discuss the fees with you so that you understand them.

Insurance Eligibility

Almond Dental Care will, as a courtesy, place eligibility phone calls and try to obtain as much information as your insurance carrier will provide. Based on the new HIPPA Privacy and Paperwork Reduction Act, that may not be much. Also, as a courtesy, we will help you by filling out the insurance forms for services rendered, and for requesting a Pre-treatment estimate quote. It will take 3-6 weeks before we receive a reply showing how much your insurance estimates they will pay when certain conditions are met.

Dental Claims & Co-Payment

As a courtesy, our office will file claims and deal with all insurance matters for you, however, your insurance policy is a contract between you and your insurance company. We are not a party to that contract. In the event we do accept assignment of benefits and your insurance company has not paid your account in full within 45 days, you must pay the balance at that time.

A copy of your insurance card will be made for your file. By law, and by contract with your insurance provider, we must collect your carrier-designated co-pay at the time of service. Please be prepared to pay these amounts at each visit.

Since we find that most patients prefer to leave as soon as possible after treatment, we will collect your estimated co-pay and deductible prior to getting started.

Payment

We request payment in full for new patient appointments on the day of service unless we can obtain a reasonable assurance of payment from your dental insurance company.

• Treatment and adjuncts not covered by insurance, estimated co-payments and deductibles are payable on the day of service.
• Discount Plans – AmeriPlan Discount Plan is honored here. All treatment is to be paid at the time of service and is not subject to any further discount.
• Insurance claims not paid within 45 days will be added to the balance due which must be paid in full at that time.
• You are ultimately responsible for payment of all treatment, regardless of insurance participation. You must make sure your account with us is kept current.
• Payment options include: personal check (established patients only), cash, debit card, bank check, MasterCard, Visa, American Express, Discover, No-Interest Payment Plan, or pre-payment plan.
• For those that desire it, financing plans are available upon credit approval.

Thank You

Thank you for understanding the need for our Financial Policy. Let us know if you have any questions or concerns. We are always happy to discuss our charges and how they relate to your particular situation. We also realize that temporary financial situations may affect timely payment of your account. If such problems do arise, please contact us promptly.

Top

About Us