For your convenience, we accept Visa, MasterCard and Discover. We deliver the finest care at the most reasonable cost to our patients, therefore payment is due at the time service is rendered unless other arrangements have been made in advance. If you have questions regarding your account, please contact us at 817.225.FACE (3223). Many times, a simple telephone call will clear any misunderstandings.

Please remember you are fully responsible for all fees charged by this office regardless of your insurance coverage. We will send you a monthly statement.

Most insurance companies will respond within four to six weeks. Please call our office if your statement does not reflect your insurance payment within that time frame. Any remaining balance after your insurance has paid is your responsibility. Your prompt remittance is appreciated. We can make arrangements for a monthly payment plan but that must be implemented prior to the actual procedure.

Click here to download our Financial Policy Form

 

Technical Note:

Mac Users
You must open and submit the form in a Safari Browser and also have the latest Mac Operating System. It is important you also have the latest version of Adobe Acrobat Reader on your computer in order to submit your form to our office correctly, please download the free plug-in from Adobe's web site.

PC Users
Our online registration forms use the Adobe Acrobat Reader 5 or greater plug-in to conveniently submit your health history and registration information from home or work. Please download the free plug-in from Adobe's web site if it is not already installed on your system. It is important that you have at least version 5 of the plug-in to successfully use our online registration forms.