Patient Information
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Financial Policy
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Care Credit
Non-Surgical Root Canal
Endodontic Retreatment
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Financial Policy
You may do the following...

Pay in Full
For all Root Canal Treatments and Surgeries a 5% discount will be
provided if payment in full is tendered by CASH or CHECK at time of scheduling,
prior to treatment or at initial treatment visit. This is a courtesy for patients who
do not have insurance, or if you have insurance and want to pay the full amount of the
procedure and have your insurance reimburse you.

(Arrangements must be made prior to your treatment): 1/2 of balance at initial
treatment visit and balance to be paid in full at final treatment visit.

Healthcare Financing:
CareCredit is offered/ and accepted. CareCredit is convenient healthcare financing
with little or no interest rate. Payments can be extended over a period of time with a
monthly payment that is convenient for our patients.

Dental Insurance:
Please remember that your dental insurance is your responsibility.. but we can help. Regardless of what we might calculate as your dental benefit in dollars, we must stress
the fact that you, the patient, are responsible for the total treatment fee. As a courtesy
to you, we can accept assignment of benefit payments from most insurance companies.
This will reduce your immediate, out-of-pocket expenditures. We do not accept
assignment of benefits on consultation visits, which means you will need to pay for the
visit and then we will have the insurance reimburse you. We do require your %down at
your treatment visit. If we do not know what your % is, we will ask that you pay at least
25% down at the time of treatment. **We do NOT accept assignment of benefits on
Medical Claims; you will be responsible for the treatment fee at the time of service.
We will be glad to assist you in filing for medical claims if you need help.

Sean P. Hart D.D.S ,M.S.D., P.C.
1533 Kossuth St. Lafayette Indiana 47905
p: 765-742-8792