Thank you for choosing Fusion Dental Care. Our mission is to provide the highest standard of comprehensive dental care. The following policies outline our financial expectations and options to ensure transparency and facilitate your treatment experience.

Please review each section carefully. Patient (or guardian) acknowledgment is required.

Treatment Fees

Our fees reflect the use of high-quality materials, reputable laboratories, and the time, skill, and expertise involved in your care.

All fees are customary and appropriate for the local area and the level of service provided.  

Payment Methods

We accept cash, personal checks, Visa, MasterCard, American Express, and Discover.

For extensive treatment plans, we offer third-party monthly payment options through CareCredit and Cherry.  

Payment Terms

Payment is due at the time of booking, unless prior financial arrangements have been made with the Treatment Coordinator.

*I acknowledge that I have read and understand the above listed statements.*

Dental Insurance  

We accept all PPO plans and operate as an open-network, out-of-network provider.  

To ensure the highest level of care and personalized service, we do not allow insurance companies to dictate your treatment.  

PPO plans offer out-of-network benefits, which means you can still use your dental insurance with us.  

As a courtesy, we will submit insurance claims on your behalf and assist in maximizing your benefits.  

Estimated copayments and out-of-pocket portions are due at the time of service.  

This is a deposit, not a guarantee of coverage. You’re responsible for any remaining balance after insurance processes the claim.  

In cases where insurance reimbursement is made directly to the patient, full payment to our office is required on the date of service. We will still submit claims to your insurer for direct reimbursement to you.

*I acknowledge that I have read and understand the above listed statements.*

Credit Card on File Policy (Effective August 2025)  

All patients are required to have a valid credit card securely stored on file.  

Copayments are still due at the time of service.  

For balances under $100, an electronic statement will be sent; if payment is not received within 7 days, the card on file will be charged, and a receipt will be issued.  

For balances over $100, an electronic statement will be sent; payment is expected within 30 days. If no payment is received, the card on file may be charged.

You will be notified of any balance before a charge is made.  

Our Administrative Team is available to address any concerns regarding your balance prior to any charges being processed.

*I acknowledge that I have read and understand the above listed statements.*

Cancellation and Missed Appointment Policy  

A minimum of 48 hours’ notice is required for all appointment cancellations or rescheduling.  

Appointments missed or canceled without adequate notice will incur a $99 fee, which will be charged to the card on file.  

This policy ensures availability for all patients and maintains the efficiency of our scheduling. 

Missed or rescheduled appointments delay your care and prevent us from offering that time to another patient in need, as we reserve dedicated time to provide each patient with quality, personal care.

Patients who miss (3) scheduled appointments without providing appropriate notice may be subject to dismissal from the practice.

*I acknowledge that I have read and understand the above listed statements.*