If you have an appointment scheduled with our office, you may print out and pre-fill your information forms. Please download the three forms below, complete and sign where necessary for each member of the family scheduled, and bring them on your first appointment in our office.
Patient Forms - Please complete, sign and date.
Medical History – Please complete, sign and date.
HIPAA/Appointment Policy – Please complete, sign and date.
Our office gladly accepts many major insurance plans including, MetLife, Delta Dental, and Medical Mutual. We also accept Preferred Provider Plans (PPO’s) from several major insurance carriers, including many of those currently subscribed to by local employers. We do not however belong to any HMO dental plans. If you are uncertain about our insurance acceptance policy and plan membership, please feel free to contact our office at 330.468.6670.
Dental insurance is one of the most beneficial and most misunderstood factors in dental treatment today. This explanation will attempt to clear up many common misconceptions about dental insurance. Dental insurance is a contract between the employer and the patient. It has NO CONNECTION at all to the provider of dental treatment (the dentist). The extent of coverage varies greatly from company to company, and sometimes even within a company. It has absolutely nothing to do with the level of service provided by the dentist and the fee charged for these services. An often misunderstood term used by insurance companies is "UCR". This is an arbitrary fee ceiling at which the insurance company will stop reimbursement. After this ceiling, coverage for a particular procedure will cease. Again, this has nothing to do with the fee charged, but with the level of coverage negotiated by your employer.
Our office is committed to helping you maximize your insurance benefits. Because insurance policies vary, we can only estimate your coverage in good faith but not guarantee coverage due to the complexities of insurance contracts.We seek to be easily accessible to our patients, answering their questions and addressing their concerns regarding their dental care and treatment coordination.