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Payment and Insurance

envelope

We will be more than happy to help you receive the maximum benefits under your child's dental insurance policy. It is therefore, very important that you remember to complete your section of the form and sign it, so that we may file your claim for processing.

Payment is expected at the time of service. Payment can be made by cash, check, MasterCard, VISA, American Express, or Discover. Failure to pay at each visit will result in a billing charge unless prior arrangements have been made with the doctor.

The adult that brings the child to the appointment is responsible for making the payment for the services rendered.

MasterCard
Visa
American Express
Discover

IMPORTANT NOTE

Many patients request that we accept assignment of benefits from their insurance carrier. This means the insurance check would come to our office. We will be happy to do this provided you allow us to charge any amount not covered by insurance to your MasterCard, VISA, American Express, or Discover account. We will need a Pre-Authorization form on file to provide this service.

If you have any questions about your insurance or payment options, please call Our staff at (716) 689-0929 or
e-mail us at info@drpaul4kids.com.

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© Copyright 2003- Dental WebSmith, Inc. and Paul A Weiss, DDS. All rights reserved. Disclaimer: The information provided within is intended to help you better understand dental conditions and procedures. It is not meant to serve as delivery of medical or dental care. If you have specific questions or concerns, contact your health care provider.

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