Dallas Dentistry at Its Best - 972-594-4888

Office Policy and HIPAA Regulation

My DFW Dentist | Dallas & Irving TX

Thank you for choosing My DFW Dentist for you and/ or your family’s dental care! We are committed to your dental treatment being a success. Please understand that payment of your bill is considered a part of your treatment and makes it possible for us to remain a viable dental practice. Please read this policy carefully. A signed financial agreement is required prior to any treatment. If you have any questions, please do not hesitate to ask.

Payment for treatment is due at the time services are rendered. For minors, the parent or guardian bringing the child to the visit is responsible for all charges incurred. We accept Cash, Check, Visa, MasterCard, Discover, and American Express. We are also pleased to offer Care Credit, which offers NO Interest and Low interest payment plans.

It is necessary to provide all the information necessary to file dental claims on your behalf. This will include the insured’s personal information, a valid Driver’s license, and a valid Dental insurance card; with a phone number to verify benefits and a correct mailing address. If this information is not available at the time of the appointment or the insurance company cannot confirm eligibility, you will be responsible for payment in full at the time treatment is provided.

As a courtesy, we will submit a claim to your dental insurance for benefits. Please understand your insurance benefits are a contract between you and your employer. On each visit to the office you will be responsible for deductibles, co-payments, and/ or balances not covered by your insurance. An insurance estimate given by this office is not a guarantee of actual insurance payment or coverage. Filing a claim with your insurance benefit plan does not relieve your responsibility for the payment of all charges.

Missed Appointment Policy: At My DFW Dentist your appointment time is reserved just for you. If you cannot keep your appointment, please give us a 2-day notice so that another patient may have your appointment time. There will be a $50 no-show/cancellation charge if you do not notify the office of your missed or canceled appointment. If you are more than 15min. late, we consider this a missed appointment and the fee may be charged.

There will be a $35 service charge for all returned checks. Returned checks must be picked up immediately with cash or cashier’s check. Unfortunately, we are unable to hold the check for an extended period of time. After a reasonable number of attempts have been made to contact you, the check will be turned over to the District Attorney’s Office for legal action.

The office cannot carry balances over 90days; regardless of insurance. Delinquent accounts can be charged a 1.5% per month or 18% per yr finance charge. If it becomes necessary for your account to be sent to an outside collection agency or small claims court, you will be responsible for all applicable fees, charges and attorney costs.

Let us hear from you...
Thank you!
To better help you please provide the following information
There has been an error

We're sorry but we could not send your message. Please email us directly at smile@mydfwdentist.com or call us at 972-594-4888

Thank you for your message!