APPOINTMENTS:
Parents looking for dental care for one or more of their children, may call (671)477-6235/6.
After scheduling your child’s first dental visit you will receive a new patient packet.
The new patient packet will include a Front sheet, Medical History Form, Disclosure Information Form, Policy Update sheet and HIPA pamphlet. Please complete these forms and bring them in on the day of your child’s appointment.
If you’re coming from another dental office, we ask you to obtain your child’s previous dental records and their most recent radiographs (x-rays).
Also please be sure to bring in your child’s most recent immunization card.
The initial visit is usually a comprehensive initial evaluation, cleaning and fluoride treatment, radiographs may be taken as prescribed by Dr. San Nicolas.
This first visit will give you an opportunity to meet Dr. San Nicolas and for him to meet your child and identify his or her dental needs for now and the future.
Cancelation Policy.
We understand that sometimes a patient is unable to make a scheduled appointment due to unforeseen circumstances. Please keep in mind that we do require 48-hour notice (weekends not included) to reschedule or cancel your child/children’s dental appointment, failure to do so will result in a $50.00 (per patient) broken appointment charge.
Realease of Record
There will be a charge for duplication of dental records, please refer to the New Patient Packet for a complete description and fees.
INSURANCES
We accept most types of dental insurance. As a convenience, we offer a dental claim filing service. Our team is skilled in maximizing insurance benefits.
Should our office receive a denial for any services rendedered, the amount owed will be patient rsponsibility.
To keep you informed, we will mail a monthly billing statement to the mailing address provided at the time of your visit. along with your statement you will also receive a letter explaining where the balance is coming from and your account ledger.
As always, please do not hesitate to call or email our office manager , Leilani Taijeron at leilani@pdcguam.com if you should have any concerns or questions regarding your insurance coverage or account balance.
We are always happy to help.
PAYMENT OPTIONS
We currently accept most major insurances.
Payments can be made by cash, check, debit card and all forms of major credit card.
To discuss your payment options or insurance coverage, please contact the Office manager Leilani Taijeron at (671) 477-5437 or you may email her at leilani@pdcguam.com
PAYMENT OF FEES
Payment is requested at each appointment for service rendered and can be made by cash, check, Master Card, Visa, or American Express, the parent/gaurdian accompanying the child to the clinic will be responsible for payment of all applicable charges. Please keep in mind we can not send statements to anyone whom has not been authorized on the Disclosure Information Form.
Returned Checks are subject to a $65.00 bookkeeping and bank fee.
CO-PAYMENTS, DEPOSITS AND OTHER FEES
Although we strive for accuracy, copayments are only estimates. Your insurance carrier will determine the actual paid benefits for claims that we submit for treatment rendered. Any remaining balance is due, for which you may receive a monthly statement. Rest assured that our office carefully reviews all schedule of benefits by your insurance carrier. We are determined to ensure that your child will receive the optimum allowable benefit for dental treatment that your insurance policy allows. For a better understanding of your insurance be familiar with your insurance plan handbook.
Some types of procedures may require a deposit which will be applied towards your balance after treatment or refunded to you as it may apply.