Moffitt Children's Dentistry

Appointments

Patients are seen by appointments only. Because of the limited number of “after-school-hour” appointments, it is likely that your child will have to miss a part of a school day. We will furnish your child with a signed verification for the appointment time. The doctor will inform you if your child needs to miss more than part of a school day.

Late Policy

Our office tries very hard to see patients at their appointed times. We feel it reduces your child’s stress to be seen and treated without delay. However, your child’s treatment may be delayed because the doctor is giving extra time to a child who really needs it. Please forgive us, and understand that if your child needs the doctors extra time, it will be provided.

Patients who are late may be asked to reschedule or to wait for the next opening in the schedule. We see patients at their appointed times regardless of their order of arrival to the office.

Broken Appointment Policy

We realize that unexpected circumstances do arise, however, in order to provide the quality dentistry for every child; this office makes every effort to operate on a strict schedule. We, therefore, ask that you give us 24 hours notice if you are unable to keep an appointment.

Broken appointments may not only compromise the good dental health of your child, but also prevent other children, who need care, from being treated.

Our office sends out a courtesy letter after your first no show waiving our $25.00 broken appointment fee and again reminds you about our 24-hour notice policy. If a no show occurs again you will be charged $25.00 per child missing their appointment.

It is our policy that patients with three No Show appointments be asked to seek care elsewhere. If you No Show for your appointment, that means you are preventing another child from being cared for.

Consent & Medical History

Because your child is a minor, the proper written consent from a parent or legal guardian will be needed before any child can be seen. Treatment will not be rendered unless proper consent is given.

In order to ensure safe and complete treatment for your child, it will be necessary to complete a medical history. If you need assistance completing this form, please feel free to ask our reception staff, however all administrative forms must be completed for us to bill your insurance and to schedule future appointments.

Foster children must have a medical history form completed by the person most familiar with the child’s history, consent from the proper guardian, and a copy of the custody papers for our records.

Responsible Party

The person that brings the child to the office, signs the consent form, and completes the medical history, will be considered the person financially responsible for the account.

Method of Payment

Payment at time of service is expected unless a payment plan has been put in place with Care Credit. Cash, Personal Checks, Visa, Master Card, Discover and American Express cards are accepted.

Dental Insurance

For our patients with dental insurance, your estimated portion will be due at time of service. As a courtesy to you, we will file your insurance claim with your provider. An estimate will be given for any work that is done but please remember that this is only an estimate. It is your responsibility to know your insurance plan

The large number of insurance plans often makes it difficult to determine the exact amount of insurance coverage. It is not unusual after the insurance and patient has paid to have a credit or a balance due on the account. If there is a balance you are responsible for the full amount. If there is a credit you may apply it to future services or have it refunded to you.

Dental treatment for your child is diagnosed and prescribed solely on need, and is not based on dental insurance coverage. A copy of your insurance card is needed on your first visit or if coverage has changed since you last appointment. DSHS patients must have a copy of their insurance the day of the visit or they will need to be rescheduled.