We hope that you will find that we have tried to eliminate
all areas of possible confusion, and trust that you will find
this information helpful. You can download our registration
kit, which includes all of the forms you will need for your
first appointment. Please complete these forms in the privacy
of your home and bring them with you to your first appointment.
Important Information
For New Patients
Save Time on Your First
Visit:
Please take a moment to download the Patient registration
Kit. It contains all the forms that you are required to fill
out prior to your first visit. Please print all information
so that we can be sure to have correct records. Please remember
to bring these completed forms with you on the first appointment,
as well as your driver's license, and your medical insurance
card.
If you should need a referral from your primary care physician
please obtain all of the necessary forms. We are not responsible
for obtaining this document.
If you are coming to ascertain if you might be a candidate
for an Oral Airway Dilator for sleep apnea, you should have
had a sleep study performed, and bring the results with you
for your first appointment.
If you have had any other diagnostic studies performed,
such as a MRI or Scan or specific x-rays, please bring in
the report as well as the films. Dr. Alpher will not
treat any patient who is under age without a parent or guardian
being present.
We wish to be as helpful as possible by providing guidelines
for you with respect to insurance coverage. Please understand
that our office does not accept
any insurance including Medicare, however, when possible, we will assist
you with insurance questions and problems. We do not render
our services on the basis that insurance companies will pay
for services.
While some major medical carriers will cover a part of your
therapy, all insurance policies vary in their provisions and
exclusions. Obtaining insurance reimbursement for treatment
is often complicated, and we strongly advise you to read your
insurance policy or benefits booklet to become familiar with
its limitations.
Our office will provide you with the necessary medical insurance
form to file with your insurance carrier; however, it will
be your responsibility to pursue payment
from them. When charges are made for services rendered, you
will receive an itemized statement of services with diagnostic
and procedure codes required by the insurance companies.
We strongly advise you to stay on top of your claims with
your insurance company. Many times, they have a question about
the claims and it remains on someone’s desk for two
or three weeks. If you do not call and follow-up, you may
never know that there is a problem. It has been our experience
that the following steps may help to get your claim processed
within an eight week period with little problems.
Call your insurance company two weeks after the services
have been rendered and ask if your claim has been received
and is being processed. If they have not received the claim,
check your records as to when you sent it and call them
again in one week.
At five weeks, if payment has not been received, call
again and find out where in the system the claim is now.
If they state that additional information has been requested,
check with our business office on the status of that request.
Often times, we have not received such a request and you
may need to call them back and have the request either mailed
or faxed to us.
Make copies of all claims and correspondence sent.
We have a relationship with you, and you have a contract
with your insurance company. Your account is your
responsibility, and the insurance company has a responsibility
to you to pay their covered part of the claim.
While I would like to "guarantee" the results of treatment,
it is impossible to do so because we are dealing with the
human body. During treatment, we do our very best to insure
your symptoms do not return. However, there are 4 types of
stress that are highly influenced by your lifestyle, and only
you can be responsible for these.
Dental Stress
Structural Stress
Nutritional Stress
External Stress
If symptoms do reoccur in the future, we will be happy to
help you in any way we can. There will be additional fees
for any services that we provide.
In most cases, we will want to see you periodically after
your treatment is completed. This is especially true if a
correction to your bite has been made. Usually, the requested
interval after treatment has been completed is 6 months after
the first year, and then once a year beyond that time. In
addition to this, you should see your family dentist on a
regular basis.
During regular business hours, the business office personnel
handles all appointment changes and takes messages to be relayed
to the doctor. Please let them know if the doctor has requested
that you call to report on your condition. As a general rule,
they have been instructed not to call the doctor to the phone
during business hours, except in cases of emergency. This
enables us to give you better service during your appointments.
Your calls will be returned as soon as time is available during
the day or after hours.
We accept cash, personal checks, Visa/Master Cards,
& Discover. We are a fee for
service based office, and do not accept any insurance
assignment. Should you require any assistance with payment,
we also offer Care Credit which allows you to take up to 3 months
interest free to pay the
bill, and you may apply for this line of credit right in our
office.
Please be advised that additional fees for requested special
services such as reports, letters, documentation, file copying,
duplicate radiographs, etc. will be assessed to you. Depending
on the nature of the service, fees will begin at $25.00.
We ask that all patients arrive on time as various appointments
are scheduled so that we can run on time barring any unusual
circumstances or emergencies. We respect your time, and always
endeavor to work in a timely manner. Should you find that
you will not be able to arrive on time, we request that you
notify us so that we may either reschedule your appointment,
or have you come at an alternate time of the day.
We require 48 hour notice of cancellation. Please be considerate
of this, as it allows another patient who may be in pain to
be seen at your appointment time.
We will not schedule any patient for further treatment if
he/she has missed two (2) appointments without 48 hour notice.
These appointments are individualized for you and we hope
that you will honor our request for cancellations.
Patient
Kit
All downloaded documentation is vital to you receiving proper
treatment. It is imperative that you bring
all these forms completely filled out to
your first appointment.
