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At your first
visit you will be asked to fill out a chart. The information you provide here
will help us to bill you or your insurance. Our office takes the position that the determination of proper treatment is a matter to be decided between doctor and patient. Your treatment needs should not be dictated by an insurance company.
Please assist us by providing the following
when you visit our office:
Your surgical referral slip (provided by your General Dentist) Most recent X-rays showing the specific area Your Dental insurance Card or Claim form If having General Anesthesia or Sedation,
do not have anything to eat or drink for 8 hours prior to surgery, and have a
friend or family member to drive you home
As payment we accept cash, check, Visa, Mastercard and Discover. We will also gladly bill your insurance. However you are ultimately responsible for all balances owed.
As a courtesy, we are happy to complete insurance forms for both medical or dental coverage. As you may be aware there are hundreds of policies and guidelines. We recommend you become well acquainted with your plan (read between the lines). For the most reliable and accurate information on your policy, your plan booklet, or human resources at your place of employment will help. Ask us to explain and help you understand any medical/dental terms or codes.
To assist us we ask you to provide us with the most current insurance information including name, group number, claim address, employee name, social security number and date of birth.
Please be aware of certain things that may hinder processing, including a change in insurance companies, age restrictions,
and student verification that may require a report card or current school registration. Some policies pay the patient and not the provider of care. It then becomes your responsibility to pay your dental bill.
Some insurance companies, such as Guardian,
may require you to bill the medical first for surgical procedures. We may ask
you to inquire as to oral surgery benefits through your medical carrier. They
can provide you with a list of exclusion and limitations if medical does not
provide coverage.
Patients with insurance will be expected to pay an estimated co-payment the
day services are provided. We are willing to work with the needs of each patient; however, we will not allow a payment schedule to exceed one year past the day of service.
Pl ease feel free to contact the
office regarding any questions or concerns at 408-356-3146.
14511 SO. BASCOM AVE.
LOS GATOS, CA 95032
(408) 356-3146
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