Insurance and Billing

Financial Policy

Our office is in-network with most major insurance companies. On your first visit, we expect you to supply us with your insurance information and a photo ID. If any changes should occur during the time you are a patient, it is your responsibility to inform us about those changes. We cannot be responsible for claims submitted to insurance companies by which you are no longer covered.
As a courtesy, we will gladly bill your insurance carrier. While we accept most insurance plans and are happy to aid in the submission of your claims, it is your responsibility to read your policy and understand that it is a contract between your employer, your insurance company, and yourself.

Please be aware that some (and perhaps all) of the services rendered may not be covered by your individual plan, and you are ultimately responsible for payment on the account.

We cannot accept responsibility for collecting an insurance claim after 90 days, or for negotiating a disputed claim. If nonpayment is received on an account after two monthly statements, our office will make every effort to contact the responsible party.

If the party responsible cannot be reached, a third bill will be sent to indicate “This will be the final notice for payment.” If the party fails to contact our office after receiving this notice, the account will be sent to a collection agency.

Should this occur, it is agreed that the financially responsible party shall pay all finance charges, collection costs, attorney fees, and any other costs that may be incurred to enforce collection of any amount outstanding. In addition, a 35% collection fee based on the balance of the account will be added.

We ask that you pay your estimated patient portion of the bill at the time of service. We accept cash, all major credit cards, personal checks, and financing from CareCredit. For all checks returned due to non-sufficient funds, a $35 fee will be added to your account.

If an insurance company pays more than anticipated, and thereby creates a credit for the patient, we are happy either to refund the patient or to leave the credit on the account to be applied toward future treatment.
The original dental record, including but not limited to treatment notes, X-rays, and study models, are the property of Clark Pediatric Dental Group. These originals will not be released to patients or other healthcare providers without written request.

I understand that a $25 fee may be applied to my account for duplication of my dental records and X-rays.

Click here to download our Financial Policy.



Dental insurance is intended to be an aid in receiving dental care. Many patients believe their insurance pays 90% to 100% of all dental fees. This is not true! Most plans pay only between 50% to 80% of the average total fee. Some pay more, some less.

The percentage paid is usually determined by how much you or your employer has paid for coverage, or the type of contract your employer has set up with the insurance company. For non-preventive dental treatment, we will ask you to pay 20% of the treatment cost at the time the service is rendered.


You may have noticed that sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist’s actual fee. Frequently, insurance companies state that the reimbursement was reduced because your dentist’s fee exceeds the usual, customary, or reasonable fee (UCR) used by the company.

A statement such as this gives the impression that any fee greater than the amount paid by the insurance company is unreasonable or well above what most dentists in the area charge for a certain service. This can be very misleading and simply is not accurate. Insurance companies set their own schedules and each company uses a different set of fees it considers “reasonable.”


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