New Patient Information

Financial Information

 

Payment for Service

The payment for medical and dental services is the patient’s responsibility. Our policy requires payment for services at the time the service is performed. If other arrangements are needed, please ask so that we may assist you.

Please make checks payable to AOMSA.

Insurance

  • CONTRACTED INSURANCE PLANS (HMO, PPO, DMO, etc.)
    If our office has a contract with your insurance company, we will file all claims with them. You are responsible for payment of estimated co-insurance or co-pay due, at the time of service. It is the patient’s responsibility to obtain required authorizations from the insurance company or primary care physician for each visit. Failure to have a current authorization could result in (1) rescheduling your appointment or (2) payment in full for all services relating to this appointment.
  • NON-CONTRACTED INSURANCE PLANS (Indemnity Insurance)
    Filing your claim does not take the place of your responsibility to pay for services received. We ask that you pay your estimated co-pay, deductible, co-insurance, or non covered services at the time of your appointment.

It is important to recognize that your insurance policy is an agreement between you and your insurance company. Your benefit assignment does not take the place of your responsibility to pay for services received. Austin Oral & Maxillofacial Surgery is NOT responsible for determining or confirming insurance benefits. Verification of benefits is not a guarantee of payment by your insurance company; final determination is made by your insurance company at the time the claim is received. We do not coordinate benefits with secondary insurance carriers.

After we receive final payment or denial from your insurance company, you will be billed for the remaining balance on your account. If, after 60 days, your account remains unpaid, you will be responsible for the balance, and service charges of 18% APR will begin to accrue. In the event of an overpayment on your account, a refund will be sent to you within 60 business days.

Please make checks payable to AOMSA. We do not accept temporary checks. A $35.00 fee will be assessed on returned checks.

In cases of divorced parents, the parent bringing the child to the initial visit will be deemed responsible for payment. Our office will not become involved in custody disputes over which parent is the responsible billing party.

Finance Program

We also offer, to qualified individuals, a 12-month no-interest finance program called CareCredit. You may apply online or in our office. If you apply online, please be sure to bring all paperwork with you when you visit our office.