Financial Policy

Thank you for choosing our office for your dental needs. Dental treatment is an excellent investment in an individual’s medical and psychological well-being. Financial considerations should not be an obstacle to obtaining this important life enhancing care. We are always available to answer your questions and/or assist you in any way we can. 

 

At the onset of your treatment we will provide you with an estimate of the total fees expected. Please understand that it will be an estimate only. Treatment sometimes changes for a variety of unforeseen reasons.

 

Fees less than $300 are due and payable at the time treatment is rendered. We accept cash, personal checks, credit cards (VISA, MasterCard, Discover and American Express) and Care Credit.

 

For our patients with dental insurance: We are happy to assist you in filing the necessary forms to help you receive the full benefits of your coverage. When it comes to estimating insurance payments or coverage, we must also stress the word estimate, as insurance companies continue to surprise us at times. Please remember that the contract for your insurance coverage is between you, your employer, and your insurance carrier. If the insurance company pays more than expected, you will receive a refund. If they deny your eligibility after the fact, the balance becomes your responsibility.

 

Payment Options

  • Payment as Services are Rendered:
    If you wish to pay the estimated amount for treatment at the time services are rendered, we gladly accept cash, personal checks, and most major credit cards. Because we cannot guarantee your exact insurance coverage, there may be a balance remaining after your insurance payment is received. Whenever choosing this option, we ask that you leave a credit card on file for any balance that may be owed.

  • Monthly Payment Plans Available for Amounts Over $300:
  • “Same as Cash” Six-Months Interest-Free
    Available through Care Credit
  • Extended Payment Plans – 24 to 60 Month Low Interest
    For financing $1000 and over
    Available through Care Credit

  • “Lay-Away” Plan
    Treatment commences after comfortable monthly payments are made which equal the estimated patient portion.

  • *3 Equal Monthly Payments
    25% initial down payment
    Guaranteed with major credit card AND secondary form of payment

 

Any insurance estimate given by this office is not a guarantee of actual insurance payment. You are ultimately responsible for all charges incurred for dentistry performed upon yourself or your dependents in this dental office. Any insurance claim not paid in full after 60 days will become your responsibility to pay at that time.


*Restrictions Apply. Reserved for “friends of our practice”. Ask us how we become friends!

 

Any balance left unpaid for 45 days, without signed, written financial arrangements, will be assessed a $35 collection fee and will be turned over to TekCollect for collection. An NSF check or failed charge with your credit card on file will incur a $35 missed payment fee and any additional cost necessary to collect the payment (including but not limited to a $35 collection fee).

 

Revised 4/2019

 


Woodland Hills Dental Wellness Program 

 

WHAT IS Woodland Hills Dental Wellness Program?

Our Woodland Hills Dental Wellness Program promotes healthy smiles and healthy bodies! It is an annual Reduced Fee Dental Program that has been instituted by Dr. Dillard to deliver quality dental care services to families like yours at prices that make sense for today’s economy. The Woodland Hills Dental Wellness Program offers the economies of group dental care . . . plus the individualized attention of private care.

HOW DO I RECEIVE CARE?

To receive care, simply call our office at (817)595-2458 and schedule an appointment.

WHO IS ELIGIBLE?

All patients are eligible to join. In order to take advantage of the reduced fee for children, a parent or guardian must also join. Children joining without a guardian will pay the adult member fee of $275.

PATIENT PAYMENTS

All payments are made directly to the dental office. As treatment is performed payments are made prior to each appointment. You should discuss all future payments and costs before new appointments are made. For patients with dental insurance, your insurance plan is considered primary. Dental claims will be filed for treatment completed. Your Wellness Program will be treated like a secondary plan. What this means is that once you use up your dental benefits from your insurance plan, you will be entitled to the discount provided by the Wellness Program.

WHEN WILL BENEFITS BEGIN?

All benefits begin the day you join and continue for 12 months. No refunds will be given if member drops out of the program during the course of their 12 month membership period.

WHAT IS THE COST?

ADULT MEMBER (age 18 and up) = $275 CHILDREN (up to age 14) = $125 CHILDREN (Age 15-18) = $175

WHAT ARE THE BENEFITS?

For one annual fee, our members are entitled to 1 regular exam and up to 2 problem focused exams with Dr. Dillard, any and all necessary x-rays. Members age 15 and up are entitled to up to three preventive cleanings throughout the year. Under 15 are entitled to two preventive cleanings. Members with diagnosed gum disease are not eligible for preventive cleanings but can still benefit from 3 periodontal maintenance cleanings for a $41 copay per visit*. Other benefits include up to a 15% discount on diagnosed treatment. *Periodontal maintenance cleanings follow active treatment for gum disease.

HOW DO I JOIN?

Fill out the attached enrollment form below and give it to any staff member or mail it to:

Woodland Hills Dental Wellness Program
6617 Precinct Line Rd., Suite 100
North Richland Hills, TX 76182


DENTAL LIMITATIONS AND EXCLUSIONS

  1. Demonstrated non-compliance with recommended course of treatment.
  2. Services which in the opinion of the attending dentist are neither necessary nor recommended for the patient’s dental health. (Example: cosmetic services)
  3. Restorations, splints or other appliances used to increase vertical dimension or restore occlusion.
  4. Oral surgery requiring the setting of fractures or dislocations.
  5. Treatment of malignancies, cysts or neoplasms or congenital malformations, except congenital anomaly of a tooth or teeth covered from birth.
  6. Dispensing of drugs not normally supplied in a dental office.
  7. Hospital benefits for any dental procedure.
  8. Loss or theft of dentures or bridgework.
  9. Any experimental procedures.
  10. Services for injuries or conditions which are covered under Worker’s Compensation or Employer’s Liability laws. Any service which is provided without cost to the member by any municipality, county, or other political subdivision.
  11. General anesthesia, IV sedation, or conscious sedation.
  12. Services that cannot be performed because of the general health, physical or psychological limitations of the patient.
  13. Periodontics, endodontics, oral surgery, or pedodontics requiring the services of a non-participating dentist. (A referral).

For additional information call:

(817) 595-2458

NO DEDUCTIBLES, NO MAXIMUMS, NO CLAIM FORMS=SAVINGS TO YOU

 

Member Registration




  • Street Address

    Street Address 2

    City

    State / Province

    Postal / ZipCode

    Country
  • Area Code - Phone Number
  • Area Code - Phone Number
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  • Dependent #1



  • - -
  • Dependent #2



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  • Dependent #3



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  • Misc

  • By submitting this form, you agree to the following: I understand the benefits, limitations, exclusions, and requirements of the Plan and I agree to the following: Fees for dental services are due as services are rendered. Fees for prosthodontic and cast restoration services are due at the preparation/impression visit. Failure to comply may result in my being charged usual and customary fees for such services. I agree to pay any and all costs in collecting all charges, including but not limited to attorney fees and court costs. Membership fees are not refundable.

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