Lundstrom Family Dentistry - Payment Options, Dental Forms & FAQ's
PATIENT FORMS
Please click the link below to view a copy of our office HIPAA policy. If you have any questions please contact our office.
RELEASE OF INFORMATION FORMS
ROI to Transfer Records to Lundstrom Family Dentistry.pdf
ROI to Transfer Records to Another Dental Office.pdf
ROI for Lundstrom Family Dentistry to Correspond with your Physician.pdf
ROI for your Physician to Correspond with Lundstrom Family Dentistry.pdf
PAYMENT OPTIONS
For your convenience, we accept cash, personal checks, money orders, and all major credit cards. We share a portion of our credit card processing fees with our customers. This means that when you pay with a card, you will be bearing a portion of the fees that we get charged when you use that card. All credit, debit, HSA, and Flex card transactions will incur a non refundable 4% credit card processing fee.
Payment is expected at the time services are performed. Feel free to contact our office if your treatment plan requires more comprehensive dental work and you want to discuss financial arrangements.
DENTAL INSURANCE
We are happy to process your insurance claims to maximize your benefits. Although we are able to submit insurance claims on your behalf, we are considered an out of network provider for all insurance plans. We do collect payment on the day of service, however, if you have insurance we will estimate your insurance coverage and collect the portion we estimate not to be covered by your insurance company. Please keep in mind that this is always an estimate based on the information we receive from your insurance. If there is a variance in your insurance coverage we will notify you.
DENTAL FINANCING
As a service to our patients, we are pleased to offer CareCredit, the nation's leading patient payment program. CareCredit offers a comprehensive range of plans with low minimum monthly payments that fit comfortably into every budget.
With CareCredit you can:
- Start treatment and care immediately and pay over time.
- Pay for other medical expenses for you and your family without having to reapply.
- Use your card at over 175,000 locations including your Doctor's office, Chiropractor, Optometrist, and even the Vet.
- Pay for deductibles and treatment not covered by insurance.
- Have no annual fees.
- Get Pre-Approval, the only information we need for Pre-Approval is your name and address.
Online Application:
- Go to www.carecredit.com
- Fill out the application
- Receive approval immediately
- Contact our practice to schedule treatment
Care Credit Promotional Plans Offered at Lundstrom Family Dentistry:
- 6 Months Deferred Interest for amounts $200.00 and up
- 24, 36, 48 Months with Interest for amounts $1000.00 and up
- 60 Months with Interest for amounts $2500.00 and up