Important Information About Your Digital Patient Records and Payment Options

Please read for updates to our Digital Patient Records and Payment Options and Policies.

1. Digital Patient Records

From your dental and medical history to your insurance information, your patient records are very important for us to be able to treat you properly.

With the latest upgrade of our office software, it is now easier than ever for you to share your patient information digitally. Moving away from paper avoids unnecessary waste and provides a simplified more streamlined patient experience.

Before your next visit, we will be sending you a text or email asking that you review and update your patient information on a secure website. You will be able to accomplish this from a mobile device.

2. Payment Options and Policies

In an effort to support contactless checkout and more convenient payment options, we have updated our payment options and policies to the following:

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Option 1: Credit Card on file (preferred)

For your convenience, your card will be kept on file and charged for any patient balance. When we receive an EOB (Explanation of Benefits) from your insurance company any remaining patient portion will be charged to your card on file. Your credit card information is encrypted and kept confidential and secure. Please contact the office, and give your credit card of choice to one of our front office team members.

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Option 2: Email Statement.

We will send an e-statement with a simple click to pay. Any balances not paid within 21 days will incur a $25.00 late fee.

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Option 3: Paper Statement.

Incurs a $5.00 per statement fee. Any balances not paid within 21 days will incur a $25.00 late fee.

These policies go into effect 6/1/21. Please notify our office prior to that date as to your payment of choice. If you have not selected option #1 or #2 with us prior to 6/1/21, you will continue to receive paper statements from our office with a $5.00 per statement fee. As always, we look forward to serving and treating you with the highest level of care.

Sincerely,

Maricopa Family Dentistry and Orthodontics