How are Appointments Scheduled? 
Do I Stay with My Child During the Visit?
What About Finances?
Office and Financial Policies Form

We anticipate a long-term relationship with our patients and their families, so keeping up-to-date in communication and payment is important.   It is our goal that families with or without dental insurance be able to afford quality dental care.  Working together, we hope to ensure your child enjoys good oral health and a smile that lasts a lifetime.

Payment at the time of service is expected unless prior financial arrangements have been made. Our fees remain the same for everyone regardless of insurance coverage. We have a traditional “fee for service” structure, and the parent who authorizes dental care is responsible for payment. For your convenience, we accept the following forms of payment: CASH, CHECK, VISA, MASTERCARD AND DISCOVER.

PATIENTS WITH INSURANCE: We will be expecting co-payments at the time of service. Please take the responsibility to be familiar with the terms of your own insurance policy and be prepared by having your checkbook or credit card with you on treatment day. We can file dental insurance claims for you and accept assignment of benefits to our office policy. You are responsible for your balance due regardless of anticipated insurance coverage.

OTHER DETAILS:

• Keep us informed of any changes in your child’s health history.

• Please make sure you have updated insurance information on file with us.

• If you miss 3 months of payment, you will be placed as a CASH ONLY ACCOUNT for all future dental services.

• A fee of $35.00 per child is applied to your account for each broken appointment.

Palos Heights, IL Pediatric Dentist - Dr. Ned L. Savide