Financial Policy for Red Arrow Dentistry

 At Red Arrow Dentistry our goal is to make it easy to do business with us. For those with insurance, we make every attempt to maximize your insurance benefits. For those without insurance, we make it our mission to provide as many payment options as possible to fit any budget.


We base our fees on the high quality materials we use, excellent equipment, trained doctors and staff, yet we still offer some of the lowest rates in the region. We will assist you with determining your benefit eligibility, calculate your costs and maximize your insurance benefits all before treatment begins. We will be sensitive to your financial requirements and make every attempt to offer the most affordable payment options possible. However, understand that ultimately you are responsible for payment regardless of any insurance company’s arbitrary determination of usual and customary rates.


Payments Due at Time of Service:

Payment for services is due at the time services are rendered unless prior arrangements have been made. We accept cash, checks, Carecredit, and all major credit cards. Checks that are returned to our office from your financial institution are subject to a $25.00 returned check fee.

Red Arrow Dentistry provides numerous payment options to fit any budget. Give us a call, drop us an email or visit our website for a complete listing of payment options. We will be happy to answer any questions about payment options while you are in the office.


Submission of Insurance Claims:

As a courtesy to our patients we are happy to submit the claims necessary to see that you receive the full benefits of your coverage. However, we cannot guarantee any estimated coverage. Your insurance policy is an agreement between you and the insurance company, the terms of which are negotiated between you and/or your employer and the insurance company. Thus, insurance plans vary widely even with the same insurance provider or employer.

Red Arrow Dentistry will file all claims electronically on the day of service, however all patients are ultimately responsible for payment of services. Please note we will do everything possible to see that you receive the full benefits of your policy.


Rescheduling/Change in Schedule:

At Red Arrow Dentistry, our patients are number one. Nothing we do on a daily basis is more important than our patients.  When an appointment is made this time is RESERVED especially for you. Our doctors and dental team spend extensive amounts of time preparing for your visit. Charts are reviewed, operatories are set up for your specific procedure, materials are prepared, etc. As a result, broken and missed appointments are one of the biggest expenses we incur, resulting in higher fees for everyone. Broken and missed appointments also prevent other patients from scheduling timely appointments.

If you find that you must change your reserved time we require a minimum of 24 hours notice so that we may make every effort to accommodate other patients. Rescheduling or canceling a reserved time with less than 24 hours notice 3 times in one calendar year may result in dismissal from the practice. Failing to show for a confirmed reserved time will result in an immediate dismissal from the practice.


Fee Reductions:

Cash Fee Reduction:

Patients paying the full fee amount at the time of service or prior receive a 5% discount. 


Senior Citizen Fee Reduction:

Our seasoned citizens (65 or older) are eligible to receive a 10% discount at the time of service.


Only one fee reduction is allowed per treatment.

NOTE: We cannot give a cash discount when insurance coverage is involved, as it would be a violation of federal law.



In case of divorce or separation, the party responsible for the account prior to the divorce or separation remains responsible for the account balance to that point. 

After a divorce or separation, the parent authorizing treatment (makes the appointment) for a child will be the parent responsible for those subsequent charges payable at the time of the appointment even if the non-authorizing parent brings the child to the appointment. The authorizing parent must make arrangements for the fee to be paid at time of service. 

If the divorce decree requires the other parent to pay all or part of the treatment costs, it is the authorizing parent’s responsibility to collect from the other parent.



If someone other than the minor’s parent or guardian brings the minor/child in for dental treatment, a signed and dated consent along with a contact number from the parent/guardian must be provided at the time of the appointment authorizing consent for treatment. For your convenience we have a short authorization form prepared and available on our website. 


Charges to Account:

We shall reserve the right to cancel your privilege to make charges against your account at any time. Future visits would then need to be paid in full at the time of service. 


Insurance Release:

You authorize Red Arrow Dentistry to release any necessary information requested by your insurance carrier and authorize payment direct to Red Arrow Dentistry for any benefits available under your insurance plan.


Past Due Accounts:

We realize that temporary financial situations may affect timely payment of your account. If such problems do arise, we encourage you to contact us promptly for assistance in the management of your account. Most often, financial misunderstandings can be managed with a phone call. Please feel free to contact our wonderful staff at any time to discuss any concerns you may have.

Although rare, we reserve the right to use all legal avenues to collect past due accounts including small claims and collection agencies. If such action becomes necessary you agree to pay all applicable attorney and collection fees, court costs, etc.


Finance Charges:

All patient balances not paid within 60 days shall automatically incur a finance charge equal to 1.75% of the outstanding balance each month (21% annual) unless a payment agreement is in place. In-house payment arrangements may include a finance charge. This charge may vary but is fully disclosed in the payment agreement. Finance Charge terms for third party providers such as Carecredit are dictated by the third party provider and not by Red Arrow Dentistry. If an in-house payment plan becomes 30 days or more past due, the interest rate shall increase to 21% APR or 1.75% monthly for the remaining life of the payment agreement. 


Late Charges:

A late charge will be imposed on each item of your account which has not been paid within 60 days of the charge being incurred unless other payment arrangements have been made. The late charge will be computed at the rate of one & three quarters percent (1.75%) per month or an ANNUAL PERCENTAGE RATE of twenty-one (21%) percent. This late charge does not apply to amounts due for insurance in process. Late charges shall be assessed on payment agreements if payments are made after the grace period in accordance with the terms in the payment agreement contract.


Pre-Payment Plan:

Pre-payments on account for future procedures are placed in an escrow account and held in place until such time the patient uses the funds for procedures at Red Arrow Dentistry. Funds are not co-mingled with the company’s operating account. These funds are not transferred to Red Arrow Dentistry’s operating account until the procedure is completed. Pre-paid funds can only be used for procedures at Red Arrow Dentistry. Patients may not withdraw funds for other purposes. All pre-payment deposits are made by automatic draft from a debit or credit card in order to be eligible.


Waiver of Confidentiality:

You understand if this account is submitted to an attorney or collection agency, or if we have to litigate in court, the fact you have received treatment from our office may become a matter of public record.



Thank you so much for choosing Red Arrow Dentistry as your dental provider.  We look forward to working together as partners in keeping your dental health.

 Revised 4-13-16

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