Financial and Insurance Options

We offer a variety of financial options so that payment is comfortable.  Payment is expected after each appointment is provided.  Cash, personal check, Visa, MasterCard, American Express, Discover and Care Credit are all acceptable forms of payment.  Third-party financing is also available for qualified applicants.

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Practice Agreement

Thank you for choosing us for your child’s dental care.  The doctors and staff of Frederick Pediatric Dentistry have been specially trained to provide comprehensive dental care for your child in a fun and educational environment.  Affordable service, when provided on a timely basis, can avoid more costly procedures later.  To minimize administration costs, we ask that you be aware of the following:

A)  Payment is due at the time service is rendered unless prior arrangements have been made.  To ensure that payment is comfortable, we offer a variety of financial options.  Cash, personal checks, Visa, MasterCard, Discover, and American Express.  If it becomes necessary to bill you and payment is not received by the due date posted on the statement a late fee of $20.00 will be assessed for each month a payment is not received.

B)  Insurance: Your insurance coverage is a contract between you, your insurance company, and your employer.  We are not a part of the contract.  We will be happy to bill your insurance carrier(s) if we are a participating provider with that insurer.  If we do not participate with your insurance, payment is due in full at the time that services are rendered.  Any co-insurance is also due at the time that services are rendered.  Although we attempt to estimate your portion due at time of service, this is only an estimate!   The exact amount can only be determined after receipt of insurance payments.  In the event that your dental plan determines a service to be not covered, you will be responsible for the total charge for that service.  Should that occur, payment is due at the time of service.  Some dental insurance companies require you to obtain a referral or preauthorization from a referring dentist prior to your child’s visit with us.  It is your responsibility to obtain this referral before your child’s appointment.

C)  Frederick Pediatric Dentistry, LLC reserves the right to add such fees as may be required to affect collection of a default account and is entitled to fully recover such collection and reasonable attorney fees, in addition to the account balance and interest owed, as may be incurred in any collection or litigation action.  If there is an outstanding balance not paid within 60 days of the date of service, the practice reserves the right to automatically charge the account of the party responsible.   

D)  Missed Appointments:  Appointments are reserved in advance for your child.  We require that you give us a 24-hour advance notification for any scheduling change, because your child’s individual appointment time with the Doctor impacts the medical and dental health of our other patients.  Missed appointments will be charged at the rate of ($25.00).     

E)  Returned Checks will be subject to a $28.00 processing fee.  Please be advised that if your check is returned to us for non-sufficient funds we will only accept Cash and/or Credit thereafter.

F)  Divorce:  We understand that many families are in a state of change.  In case of divorce or separation, the parent requesting treatment for the child will be held accountable for any charges for services rendered.  If the divorce decree requires the other parent to pay all or part of the treatment costs, it is the requesting parent’s responsibility to collect from the other parent after settling their account with Frederick Pediatric Dentistry, LLC.

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Participating Insurances as of December, 2010

• Maryland Healthy Smiles, including REM
• This includes:
  • Amerigroup
  • Priority Partners
  • Dentaquest
  • United Healthcare Dental MA
  • MD Physician’s Care
• Aetna PPO
• Careington Discount Plans (PPO and POS)
• Cigna PPO Radius Network
• Delta Dental
• Guardian
• Humana
• United Concordia, including Tricare (no HMO)
• United Healthcare PPO

If your dental insurance is not listed here, we are still usually able to submit claims on your behalf.  Every insurance plan differs.  Even if your insurance is one that we participate with, we recommend that you contact your dental insurance provider before your child’s appointment so you are familiar with the coverage.

We look forward to working with you and being partners with you in your child’s overall health!