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Aquila Dental Forms, Insurance & Financial Options

New Patient Form

To quicken your visit, we have placed our New Patient Form online (in Adobe PDF format). If you are able, we ask that you download, print and fill out this form about your dental and medical history before visiting the office.

New Patient Information Form (pdf, 54 kb)

NOTE:
You will need the Adobe Acrobat Reader to view the file. You can download the reader here.

Insurance Facts

We are pleased that you have a dental insurance policy. We will do everything we can to help you maximize your benefits on a yearly basis. We ask to keep several important facts in mind:

  1. You have a maximum coverage per year of $750, $1000, $1500, or $2000. When dental co-payment plans began in 1970, they allowed the same amount of maximum payment per year as allowed today. In other words, reflecting for a 6% per year inflation, your $1000 benefit per year is equal to $290 in today's dollars. Had the various dental insurance companies increased their benefit on a year-by-year basis, reflecting increases for inflation, this year your benefit would be $3207.14 per year!
  2. We ask that you understand, we neither work for the insurance companies, nor do we wish to. We work 100% for YOU. We want to help you maximize your benefits, but also we do not want to be controlled by neither insurance companies nor the benefit packages they offer.
  3. Our office does not diagnose, render treatment or establish fees according to any insurance tables or allowances. Office fees are based on care, skill and judgment of the professionals delivering the services, and by the cost of operating a dental office dedicated to excellence. Most importantly, remember that we work 100% for YOU, not for the insurance company. As a courtesy to you, we will file insurance claims. However, it is required that your estimated portion be paid at the time services are rendered.
Financial Options

It is our firm belief that all patients who come to our office want and deserve the best dental care that can be provided. Dr. Higg's goal is to provide excellent service at a fair fee. Payment is due at the time professional services are provided unless other financial arrangements have been made in advance with our office.

Below is an outline of choices for financial arrangements:

  1. Cash, Check, Visa/Mastercard, American Express and Discover at date of service.
  2. Dental Fee Plan by Capital One: They will finance you (with approved credit) with low monthly and/or interest-free payment.
  3. Half down and balance due in 30 days.

We believe that we have a responsibility to use our best professional care, skill and judgment in planning your dental treatment. The benefits of treatment and liabilities of neglect are always explained in the written Review of Findings we will be completing for you. All fees will be thoroughly explained to you. Any type of financial arrangements made with our business coordinator, are expected to be honored and followed through. Our commitment to you is that we will never move forward with any treatment unless you agree on it and know exactly how much it will cost. No business or practice can fulfill its mission to its patients when a bond of trust is violated by failure to pay for services.