Thank you for choosing Ballard Family Dentistry for your all of your dental needs. We understand that everyone’s
financial situation is different. For this reason, we have worked hard to provide you with a variety of payment
options to help you receive the dental care you need and deserve, with respect to your budget. We are always available
to address any questions or concerns you may have. Please choose one of the following offers:
Pay As You Go
Our “Pay as you go” option allows you to be in control of your insurance benefits, by paying fully at each
appointment for treatment and by being reimbursed directly by your insurance company. This will enable you to keep
personal records of all insurance reimbursements, all dental transactions, to track maximum allowable benefits and be
more aware of what your plan covers and what it does not cover. You will never have to worry about having outstanding
account balances with us. We will make sure your insurance claims will still be filed, and that payment will go
directly to you.
Assignment of Benefits
When insurance companies reimburse patients, payment usually takes about one to two weeks to be received, especially
if the patient’s plan accepts electronic dental claims. If required, at each appointment we will send electronic
claims for you. Our “Assignment of Benefits” option offers you the convenience of using your dental benefits as a form
of direct payment by assigning payment from your dental insurance company directly to us. Please be reminded that your
dental insurance is an agreement between your insurance company and you. This means you are responsible for any
service fees or balances that may not be covered by your dental benefits plan. Balances not covered by your dental
insurance will be billed directly to you.
CareCredit for Dental Procedures
We’re pleased to accept the CareCredit credit card,
North America’s leading patient financing program. CareCredit is a credit card exclusively for healthcare services.
CareCredit offers special financing on purchases of $200 or more for healthcare procedures, not commonly covered by
insurance, including dental treatments. Plus, you can use your CareCredit card over and over for follow-up
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*Subject to credit approval. Minimum monthly payments required. Visit www.carecredit.com for
“Express Checkout” option allows you the convenience of coming in for treatment without having to check out after the
completion of your appointment. We will still submit claims to your insurance company and your insurance company will
directly reimburse you.
All there is to do is fill out our credit card authorization from below. It will be kept confidential and used
strictly under the agreed terms. We will bill your credit card after each appointment and a receipt of this
transaction will be mailed to you.
Pay In Full Discount
For patients not using insurance or have out of network insurance, choosing to pay for dental services in full at the
time of service might be a better option. For this reason, we offer a 5% pay in full discount off of the service total
when using cash or check. For patients choosing to use a credit card to pay in full, we offer a 5% discount off the
A specific frame of time is reserved especially for you and we strongly encourage patients to keep their
appointments. If you have to change your appointment, we require at least 48 hours notice to avoid charging you with
the cancellation fee.
For your convenience we accept a variety of payment methods at the time of treatment. We accept cash, Visa,
Mastercard, American Express, Discover Card, and Care Credit. We also accept most major dental insurance and are
pleased to offer long-term financing options.
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Our Secure Online Payment Center
To discuss your payment options or to ask questions regarding your insurance coverage, please call our office