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Patient Information

The following information is provided for your benefit. We believe the more informed you are as a patient, the better experience you will have while at our office.

Financial Policy

Insurance assignments (if applicable) are an agreement between you and the insurance carrier. As such we do notaccept insurance assignment. At the time services are rendered a payment of 50% of the fee is required. As a courtesy to you, we will prepare all required forms and file them electronically to expedite the reimbursement process. We will make claims against your primary insurance policy and if applicable, your secondary insurance policy. Payment will be made to Marc Bowers, DMD, PA. If your insurance company does not reimburse the remaining balance, you are responsible for the payment. In order to ensure the remaining 50% of the fee is received, a credit card pre-authorization form will be completed, granting Marc Bowers, DMD, PA permission to charge the remaining balance to your credit card. In the event the insurance company reimburses more than 50%, a refund will be issued to you and mailed to your address on file. Regardless of your insurance reimbursement schedule, any remaining balance is due in full within 45 days from the date of your initial treatment. If you do not have dental insurance, payment is due in full at time of service. Outstanding balances of greater than 45 days are subject to a monthly finance charge of 2%, corresponding to an APR of 24%.

Sterilization Policy

Each instrument used for patient treatment in our office is sterilized. Every item has been carefully scrubbed, dried, packaged and sterilized in an autoclave. This office meets or exceeds all governmental required standards for sterilization and monitoring of sterilization effectiveness. The treatment room has also been prepared just for you. Every touchable surface has been scrubbed, sprayed and wiped down with a disinfectant in accordance with OSHA and CDC guidelines, eliminating any chance of cross-contamination. Our office stays up to date on the latest compliance with the requirements of OSHA’s regulations on infection and hazard control.

Patient Forms for Download (all forms require the free Adobe Acrobat Reader)

Patient Registration Forms

Post-Operative Instuctions-Non-Surgical Therapy

Post-Operative Instructions-Surgical Therapy

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Marc Bowers DMD PA 2014