Financial Policy and Payment Options

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Financial Policy and Payment OptionsPayment is due in full at time of service.

Our office wants all of our patients to be able to comfortably afford dental care. We proudly offer the following financial policy and payment options so that our patients can have the opportunity to decide which payment option best suits their needs. If you are not sure which payment option is right for you, make sure to ask a Shamblott Family Dentistry team member for assistance. We are always happy to help.

In order to make going to the dentist as accessible and affordable as possible, we offer you these financial policies and payment options:

  • Pay in full with cash or check at the start of treatment and receive a 5% prompt payment reward.
  • Pay in full at time of service with VISA, MasterCard or Discover.
  • For patients with insurance, your estimated portion is due at time of service (cash, check, VISA, MasterCard or Discover).
  • Extended-term financing is available through Care Credit, which is a healthcare credit card that can be applied for through our office with an outside financing company. The application is called in from our office, and we usually know within an hour if your application is approved. This is a one (1) year interest-free credit card. Payments are made directly to the financing company.
  • Lending Club – Schedule treatment without delay and fit the cost into your monthly budget with a responsible payment plan offered through Lending Club Patient Solutions.

Find out more about Care Credit


Lending Club Patient SolutionsLending Club Dentist

Our practice is pleased to present flexible payment plans through Lending Club Patient Solutions. Lending Club Patient Solutions offers:

  • Plans with low fixed rates & low monthly payments that never change over the life of the loan
  • Patient-friendly, True No-Interest Plans with no retroactive interest
  • No upfront payments
  • No prepayment penalty

It’s easy to calculate your potential monthly payments. Simply complete a short application which displays exact fixed rates and monthly payments available for Extended Plans, all without impacting your credit.

For more information, simply ask a Shamblott Family Dentistry team member or visit lendingclub.com/patients.


Smile SaversAdult Cleaning and Maintenance Program

Shamblott Family Dentistry’s Smile Savers Adult Cleaning and Maintenance Program provides patients without dental insurance with routine preventative dental care and discounts on most dental treatment for one low annual fee.


Dental Insurance

It is our pleasure to assist you in preparing and submitting your claims, and helping you to maximize your insurance benefits. At the time of service, we will only ask you for the estimated portion of the dental care that is your responsibility. Please understand that this is only an estimate, and is based on the information available to us.

The financial obligation for dental treatment is between you and our office, regardless of insurance coverage. Because your dental benefits are governed by a contract between you/your employer and your insurance company, if we have not received payment from your insurance carrier 30 days after the claim is filed, the remaining balance will be due and payable by you.

The treatment we recommend is determined by what is best for your dental health. Our recommendations are based on your dental needs, not on your insurance coverage. Your insurance company may or may not cover all recommended procedures. We request that you understand your benefit plan and be familiar with the dental benefits covered by your insurance in advance of your appointment so that together we can make the best treatment decisions. If you have any questions about your coverage, we encourage you to call your insurance company’s Customer Service Center to learn more about your coverage.

Please remember that dental insurance is not designed to cover 100% of the cost of all treatment. For example, you may choose a treatment that your dental insurance excludes from coverage (i.e., a non-covered service). In those cases, you will be responsible for the full amount of those services. Our staff is happy to provide you with estimates for the treatment options you have chosen, and answer any special concerns or questions that you may have.

I authorize my insurance company to make payments directly to the dental office for benefits otherwise payable to me. I authorize release of my records to third party payers, other healthcare professionals or operations or other entities as deemed necessary by this office. I authorize the use of this signature for all insurance submissions. I authorize this office to charge my credit card or bank account for any unpaid balances, including but not limited to balances after insurance payment. I understand in certain circumstances, my credit report maybe requested. I have reviewed the information on this form, and it is accurate to the best of my knowledge. I understand check payments may be converted to automatic bank drafts. I have received a copy of the Notices of Privacy Practices form.

Extended Billing Fees

We include a monthly billing charge or finance charge of 0.5% on all balances of 60 days and older.

Broken Appointments

A specific amount of time is reserved especially for you and we strongly encourage all patients to keep their appointments. If you must change your appointment, we require at least 24 hours notice. If you do not provide us with at least 24 hours notice, we reserve the right to charge you a $50.00/hour cancellation fee.

We welcome you to our family and look forward to helping you get the healthy, beautiful smile you’ve always wanted. If there is anything we can do to make your visits here more pleasant, please don’t hesitate to ask one of our staff members.