We require payment in full upon completion of all TMJ related appointments regardless of insurance status, or type of treatment provided. Most TMJ procedures are considered medical, but there are some procedures that may be considered dental. If you have medical and/or dental insurance, please bring your insurance cards with you to your appointment so we may verify coverage and obtain coverage benefits. If your treatment will be filed with major medical insurance please be aware that we are not a participating provider for any medical insurance company and are therefore considered out of network. Once you complete your case presentation appointment you will be given a completed medical insurance claim form and other standard information required by the insurance carrier so you can file the claim and get reimbursed. Please be aware that your out of network deductible will need to be met (if it hasn't been met already) before your insurance company will begin to reimburse you.             

  • We require a deposit of $100.00 in order to reserve your initial appointment.
  • If you need to cancel the initial appointment, your deposit will be refunded if it is greater than 7 days from the appointment.
  • If you need to cancel or reschedule your initial appointment and it is less than 2 days from your appointment you will forfeit your entire deposit and will need to place a new $100.00 deposit if you would like to reserve a new initial appointment.
  • Regular appointments canceled less than 48 hours and no shows for appointments are subject to a penalty fee of $50.00 per hour of appointment time.
  • Please be aware that cancellation of a Monday appointment must occur by 4 pm the Thursday prior in order to avoid an inadequate cancellation fee.
  • Late arrivals to appointments may be rescheduled and subject to a fee.
  • Excessive inadequate cancellation and no shows will require a deposit to secure future appointments.
  • Emergency TMJ treatment (patients acutely locked closed or locked opened, and not a patient of record of our practice) are required to place a 50% deposit of the estimated appointment total in order to reserve an appointment.

Please Print And Fill Out These Forms Before Your First Visit

 


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