PATIENT INFORMATION

INTRODUCTION

 

Dr. Tate and staff are pleased to provide a pleasant visit with remarkable results by serving with dental expertise, scheduling appointments, answering financial and insurance questions. The following offers administrative information regarding our practice.

 

WHAT TO EXPECT

Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. Occasionally, treatment can be done the same day as the consultation. However, a complex medical history or treatment plan will require an evaluation and a second appointment to provide treatment on another day.

Please assist us by providing the following information at the time of your consultation:

  • Your referral slip and any X-rays if applicable

  • A list of medications you are presently taking

  • If you have medical or dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.

IMPORTANT: A parent or guardian must accompany all patients under 18 at the consultation visit. Please alert the office if you have any medical condition that may be of concern prior to surgery, i.e. diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc. or if you are on heart medication, aspirin, anticoagulant therapy, etc or require medication prior to dental cleanings.

 

FINANCIAL POLICY

FOR ROUTE 66 SMILES

For your convenience, we accept Visa, Mastercard & Care Credit for patient financing. Route 66 Smiles delivers the professional care at an affordable price for the whole family. The following is a statement of our financial policy, which we hope will avoid any misunderstanding regarding payment of your account. A $25.00 service fee will be added to any collection accounts in addition to a 2% financial charge will be added monthly.

All patients must complete our patient information sheet and present their insurance card before seeing the doctor.

REGARDING INSURANCE

Your account balance is your responsibility whether your insurance pays or not. We cannot bill your insurance company unless we have the correct insurance information. Your insurance policy is a contact between you and your insurance company. We are not a party to your contract. If your insurance company has not paid your account in full within 60 days, the balance will be your responsibility. The state law requires that your insurance company pays the claim within 30 days of receiving it or notify us as to why the payment is delayed. You should get an explanation from your insurance company advising you of the payment status. It is your responsibility to see that your insurance company pays within a timely fashion. All Co-pays and deductibles are due at the time of services. Once your insurance company pays and the necessary adjustments are made any balance due is your responsibility and should be paid promptly to avoid the possibility of losing your insurance benefits. Due to recent problems with insurance coverage, we want to inform you if pre-authorization was required by your insurance company and you failed to notify us ahead of time you will be responsible for payment of those charges in full.

 
 

OTHER POLICIES

privacy POLICy:

We are currently collecting information transmitted through our email form and data collected through our website hosting. Such data shows simple, anonymous analytics. We do not cookie. We respect your privacy. We are and will remain transparent on any kind information we receive through www.route66smiles.com. If you have any questions regarding our privacy policy you may contact us anytime during open hours. 

personal information:

By entering your personal information through our website form, Route 66 Smiles will respond to schedule an appointment. Personal information entered is used only for returning requests.

email subscription:

Opt in or out to receive any promotional material for Route 66 Smiles through our email form.

medical concerns:

The information presented on this website is for educational use only and should not be used for the diagnosis or treatment of any medical condition. Please seek the appropriate treatment for any health concerns.