To improve patient care and to maximize your positive experience at our practice, we follow these policies and procedures, which are subject to change:
*Food/Drink Policy*
Absolutely No Food or Drinks are allowed in the building. Water can be provided as needed.
*Cell Phone/Tablet Policy *
As a courtesy to others, cellular phones and tablets MUST be turned to “off,” “vibrate,” or “silent” while in the Lobby, Clinic, or any other area of the building. If you need to take a call, please step outside of the building. Cell phone use while being treated is strictly prohibited. Dr. Hithe and her staff take pride in giving their full attention to their patients and cell phones can be very distracting.
*Financial Policy*
When reviewing the financial agreement (patient contract), please note that monthly payments are due once a month on the assigned day regardless if the patient is seen on that particular day or in that particular month. A monthly payment is simply a convenient way to spread out the cost of orthodontic treatment and is not related to treatment progress or appointments; therefore, payment is still due even if there is no appointment during the month. The balance of the total treatment fee is due before the braces/appliances are removed. ALL ACCOUNTS MUST BE CURRENT IN ORDER TO SCHEDULE OR RE-SCHEDULE AN APPOINTMENT.
We do not send monthly invoices. We do give a copy of the payment schedule at the initial appointment and suggest setting up automatic withdrawal with a bank/credit card to avoid late payments. Monthly payments can be made by phone ($200 or less) or they can be mailed in via check or money order ($200 or less). We do not accept checks for the initial appointment(s), replacement retainers, or the final payment(s).
If payment is 30 days delinquent, the patient can be seen for an emergency only and no active treatment will be performed. We will check for broken or loose appliances and evaluate hygiene until the account is brought current.
If the account falls 60 days delinquent, no active treatment will occur until the account is brought up to date.
If the account falls 90 days delinquent, a DISMISSAL letter will be sent by certified mail. This will terminate our responsibility to the patient. Further orthodontic treatment will have to be rendered by another orthodontist. However, if the patient finds alternate financing and pays the entire unpaid balance, active treatment can be reinstated.
NSF Fees:
There will be a $25 Non Sufficient Fund fee for all returned checks. Additional fees will be charged for late payments. We reserve the right to no longer accept checks for that account.
*Insurance Policy*
Upon verification and assignment of orthodontic insurance benefits, an insurance ledger will be established with the amount of estimated insurance benefits. Insurance will pay provided the patient is still eligible for coverage, active treatment is still being rendered, and the lifetime orthodontic benefit has not been exceeded.
Most dental plans do not pay the provider in one lump sum. They will pay us throughout the course of treatment. If for any reason during active treatment the insurance benefits decrease, change or terminate, the unpaid balance will be transferred back into the patient’s ledger and will be the responsibility of the patient/parent.
It is the parent/patient’s responsibility to inform us of any change in coverage. We may need to ask your help in filling out forms or making calls to the insurance company. We reserve the right to refuse to process/accept insurance benefits at any time.
*Treatment Cooperation Policy*
Successful treatment is dependent on the following:
* Proper oral hygiene
* Patient cooperation in elastic wear
* Proper care of appliances (no breakages)
* Reporting broken or lost appliances promptly
* Eating the proper foods that will not cause breakages or cavities
* Keeping appointments as scheduled (broken appointments interrupts and extends treatment progress)
*Appointment Policy*
Appointments are normally scheduled at four (4) to six (6) week intervals. In order to provide quality orthodontic care, it is necessary to schedule some appointments during school/work hours. Appointments an hour or longer will be scheduled in the morning. We understand that this can be inconvenient for some patients; however, it is important to schedule lengthier appointments during school/work hours to achieve the best possible treatment.
It is up to the patient to schedule his/her own appointments on a timely basis. We highly recommend scheduling your appointment before leaving after each visit. Twenty-four (24) business hour notice is required to cancel an appointment. If an appointment is missed, it is the patient’s responsibility to contact our office immediately to set up a new appointment.
As a courtesy to you, our office will attempt to confirm your appointment 1 business day prior to your appointment (Monday – Thursday). Please do not rely on this as the only means of remembering your appointment as there could be circumstances that may prevent a reminder from going out. We offer this only as a courtesy to you.
No-Show, Same Day Cancellation, or Same Day Re-Scheduling:
Please remember that we set aside time just for you, so please make every effort to keep your appointments and arrive on time. If you are not able to make your appointment, we must be notified at least 24 business hours in advance (Monday-Thursday / 8am-4pm) to cancel or re-schedule for any reason. If you have a Monday appointment, we must be notified the Thursday before your appointment before we close at 4pm. This policy applies to consultations, initial appointments (records and/or braces), adjustments, debonds (removal of braces) and retainer check appointments.
The following fees will be assessed accordingly:
- If a patient does not show up or arrives too late for their 10-30 minute scheduled appointment, a charge of $35 will be applied to their account and must be paid at their next appointment. This applies to arriving too late for an appointment as well. We usually give a 10 minute grace period unless it is the last appointment before our lunch break or if it is the last appointment of the day(3:50pm or after). There are no grace periods for those appointments.
- If a patient does not show up or arrives too late for their 40-180 minute scheduled appointment, a charge of $75 will be applied to their account and must be paid at their next appointment. This applies to arriving too late for an appointment as well. We usually give a 10 minute grace period unless it is the last appointment before our lunch break or if it is the last appointment of the day (3:50pm or after). There are no grace periods for those appointments.
Holiday Appointments:
Our office is usually open on Martin Luther King Holiday, Easter Monday, Memorial Day, and Labor Day. If you miss, cancel, or re-schedule on the same day of those holidays, the fees increase to $50 for a 10-30 minute appointment or $90 for a 40-180 appointment. The above mentioned holidays are mentioned holidays are on Mondays and our office is closed on Fridays, therefore, we must be notified before the close of business the Thursday before that Monday if an appointment needs to be canceled or re-scheduled.
*Extra Charge Policy*
Orthodontic Breakages:
If a patient happens to break a bracket or a band, for any reason, the first breakage is free and then it is $55 per breakage after that. Payments for the breakages are due when they are re-bonded. Also, if there are any other breakages, a cost will be determined at that time. PATIENTS MUST NOT EAT HARD, CRUNCHY, STICKY FOOD OR CANDY.
Overage Charges:
ADDITIONAL MONTHLY CHARGES MAY BE INCURRED FOR EXTENDED TREATMENT TIME DUE TO POOR COOPERATION (i.e. lack of elastic {rubber band} wear, poor tooth brushing, improper diet, and lost time due to breakages or missed appointments). Your treatment may be discontinued for lack of Parent and/or Patient cooperation. Charges will be determined at the appropriate time.
Color Changes:
Please make sure that the color you choose at your appointment is what you want for the next 4-6 weeks. If a patient would like their color(s) changed prior to their next appointment, the cost is $10.
Lost or Damaged Retainers:
Most financial agreements include one set of retainers. If you require another set because they are lost, damaged or you had restorative dental work, there will be a charge for the new retainer(s). The cost will be determined at the appropriate time.
*Limited Space*
Due to limited space, only the patient and two others are to accompany the patient to his or her appointments. This will be strictly enforced. It is the policy of this office that only the patient (unless it is a consultation) is allowed in any treatment/clinic areas.
*Minors Policy*
For the safety of your child/children, no one ages 6 and under are allowed in the clinic treatment area unattended nor left unattended in any waiting areas. Unattended children could harm themselves or clinic property and disrupt our staff and others. We also want to make sure unattended children do not come into contact with unwanted germs that could make them ill. If you are being seen for an appointment and there is no other adult who can sit with your child/children in the lobby area, please call the day before to re-schedule or if it is an unexpected occurrence, please call before your appointment time to discuss the circumstances.
All patients ages 7-17 years old must be accompanied by an adult and not simply dropped off. If the adult is unable to stay for the duration of the appointment, this must be cleared by the doctor prior to scheduling the appointment.
Parents are responsible for all actions of their children and are financially responsible for any damage done to the facility. There is no running in any area of the building.
Again, it is the policy of this office that only the patient (unless it is a consultation) is allowed in any treatment/clinic areas.
*Hygiene / No Color Change Policy*
Properly brushing your teeth is a MUST. If proper oral hygiene is not maintained, permanent marks and scarring of the teeth can result. Also, if a patient presents with poor oral hygiene at his/her appointment, we would prefer to refuse the option of letting the patient pick a color of his or her choice for that visit. We will put the color grey (that matches the braces) and not any other color. If the patient presents with fair, good, or excellent hygiene, then he/she can pick the color(s) of their choice. This reward system is a helpful way to remind our patients of the importance of good oral hygiene while in orthodontic treatment. This could ultimately save the patient a lifetime of unsightly staining of the teeth.
*Dental Care Policy*
General dental care and checkups are the responsibility of the patient/parent and your regular family dentist. We advise patients to see their general dentist every six (6) months during active orthodontic treatment. In the event that you have changed dentists or there has been a change in medical history, please notify our office as soon as possible.
*Mouth Guard Policy*
The risk of serious injury to the mouth whether you have braces or not, is inherent in virtually any sport or activity that might result in trauma to the head. Therefore, it is important that you or your child wear a mouth guard while participating in any of these sports or activities. Please remember that wearing a mouth guard of any kind cannot completely prevent injuries from occurring. Hithe Orthodontics provides one free mouth guard upon request and $10 for each additional that may be needed.
*Saturday Appointment Policy (If Applicable)*
Saturday appointments will be reserved for those directly approved by Dr. Hithe (i.e. out of state college students {valid Student ID or Utility Bill will be required as proof}). Saturdays are available one Saturday a month only during the school year and not during major holiday months or summer time. Also, accounts must stay current in order to be considered for a Saturday appointment. If a Saturday appointment is canceled (even with sufficient notice) or missed for any reason, a future Saturday appointment will not be offered to that patient.
Thank you for considering our office for your orthodontic needs and we appreciate your cooperation with the above policies.
