Roseville Periodontal Treatment by Nicky M. Hakimi D.D.S., M.S.D.

Roseville Periodontal Treatment Guest Services

Dear Patient:

In our continual effort to offer you a high level of quality care, professional service and increased efficiency you deserve, it has become necessary to implement some guidelines regarding key issues of the appointment and financial practices in our office. Please read them carefully and feel free to discuss them with us.

Roseville Periodontal Treatment APPOINTMENT GUIDELINES:

We APPRECIATE your choosing us for your periodontal care. We think it is important to make your appointments as convenient as possible. We do this by giving you a date that is specifically reserved for you. It is our objective to maintain our schedule so that you can be seen and completed on time. On many occasions, we will attempt to give you long appointments so that we can do as much dentistry as is comfortable for you. This will help decrease the number of visits you will have to make to our office and also provide you with excellent continuity of care. Because of the time that we will provide, it is very important for us to receive adequate notice should you have to change your appointment. We found it necessary for our patients to give us at least a 48 hour notice if an appointment needs to be rescheduled.

FINANCIAL GUIDELINES for Roseville Periodontal Treatment:

In order to provide you with the highest quality dental care on a sound business basis, we provide our patients with an estimate of fees and arrange for a payment schedule. By establishing a clearly defined method of payment, we hope to eliminate confusion, simplify insurance claims, and provide more thorough coverage for our patients. To assist you in making payment for your dental treatment, the following options are listed. Please read them carefully and feel free to discuss them with us.

Payment in full is due at the time of service, unless other arrangements have been made with our financial coordinator. You may make payment using CASH, CHECK, MASTER CARD, or VISA. If an extended payment plan is necessary, OUTSIDE FINANCING is also available, based on credit approval.

INSURANCE PATIENTS-PLEASE READ CAREFULLY:

For our patients with dental insurance, our professional services are rendered to you, not your insurance company. Therefore, you are directly responsible to us for the obligation of payment. We will do our utmost to help you receive you maximum insurance benefit available.

If you have dental insurance, we will accept assignment from your insurance company for any estimated covered treatment. At the time of your appointment, we do request that you pay in full for any estimated uncovered portion of your care and the deductible.

The percentage of coverage by your insurance company may be based on the company's own reduced fee schedule for dental services and may be less than actual charges resulting in lower coverage for you. Lower payment is a direct result of the plan selected by your employer.

We realize that emergencies can occur. Should an unforeseen situation prevent you from making a pre-arranged payment, please contact our office to avoid the possibility of a misunderstanding.

THANK YOU FOR YOUR COOPERATION.

Sincerely,

Dr. Hakimi & Staff

Dr. Nicky M Hakimi DDS, Periodontist - Providing services in Periodontal Dentistry and Periodontal Surgery to the areas of Roseville and Sacramento, California.

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