Thomas Quickstad DDS Dentistry for All Ages

Our philosophy: Our goal is to meet everyone’s expectations and to prevent surprises and uncollectible debts. New patients will be told the costs of exams and x-rays before these procedures are started. One week before a crown, bridge or denture procedure, we will contact you by phone to notify you of your portion to be paid. Patients will always be given a walk-out statement following treatment and payment. Payment is due in full at the time of service.

Seniors without dental insurance: A 5% senior discount is applied to seniors (65 years and older). A 5% cash discount will be applied to cash or check payments made at time of service.

Patients without dental insurance: A 5% discount will be applied to cash or check payments made at time of service. Patients paying by credit card will not receive a 5% discount for payment at the time of service.

Patients with dental insurance: Patients with insurance do not receive a 5% discount on co-payments made at the time of service. You are responsible for your estimated out-of-pocket expenses at the time of service. You are responsible for timely payment on your account if your insurance company denies payment on any of your charges.

Payment plans: Payment is due in full at the time of service. You may pay by cash, check, Visa or MasterCard. If you do not pay the entire balance due on your account within 25 days of the monthly billing date, a finance charge will be applied to your account balance. The finance charge will be 12% per year (1% per month).

Cancellations: We require 48 hours notice from you to cancel an appointment. The first time you cancel without 48 hours notice, there is no charge. For any subsequent cancellations, we must charge $75 per hour of reserved time. For example, if you cancel an appointment that was scheduled to take an hour, we will charge your account $75.

I have read and understood Dr. Quickstad’s financial policies and agree to abide by them. In consideration of the services rendered to me by this dental office, I am financially responsible for any balance due, including any service charges and collection fees.