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3801 Fairfax Drive, Suite 54, Arlington, VA 22203
Financial Options AT Arlington Dental Excellence

Financial Options

Insurances:
Arlington Dental Excellence Participates and are an in-network provider with most PPO insurance plans. Some of the insurances we accept are: Metlife Dental, Aetna Dental, Delta Dental, Blue Cross Blue Shield, United Health Care, Cigna Dental, GEHA Dental And all other PPO’s
Third Party Payment options:
If you do not have insurance or your insurance only covers a portion of the cost, We are preffered partners and work along with Wells Fargo Health Savings, Lending Club, and Care Credit. These options we are able to secure payments plans with 0% Interest.
Our office handles all billing as a courtesy to our patients. Please call our dental office in Arlington, VA to make an appointment with our dentists or to ask any questions you may have.

SHINKAWA DENTAL
SAVINGS PLAN

Includes:
Teeth basic cleaning (2 per year)
Periodic oral examination (2 per year)
All Necessary x-rays*
Emergency exam **
20% savings on periodontal treatments
15% savings on general & restorative procedures.
10% savings on major procedures***
10% savings on implants and implant restorations
10% savings on over the counter products and fluoride
$299
PER YEAR

Qualifications

The in-office savings plan is an annual, renewable dental savings plan for families and individuals at Shinkawa Dental. With this plan, there are:
NO deductibles
NO yearly maximums
NO claim forms
NO pre-authorization requirements
NO pre-existing conditions limitations
Immediate eligibility (NO waiting periods to begin treatment)
Benefits and savings begins immediately upon registration.
The initial fee is $299.00 for one individual and $249.00 for the first additional family member and $199 for each additional member thereafter. Eligible family members include spouse and dependent children to age 26. The savings plan is valid for one year from registration date.

If you choose to use Care Credit to pay for the plan, your savings will be adjusted based on the Care Credit fees. The initial fee is $319.00 for one individual and only $269.00 for each additional family member. A missed appointment fee of $25 per 30 minute appointment (or 25% of treatment total for treatment over $1000) will be charged for all missed dental appointments. Please notify our dental office at least 48 hours in advance if you must change your reserved appointment. Terms subject to change.

LIMITATIONS AND EXCLUSIONS

Services unable to be completed due to the patients’ medical health, mental health, or other unhealthy status.
Conditions or services under Worker’s Compensation or Employer’s Liability Laws.
Congenital malformations other than congenital anomaly of tooth/ teeth from birth.
Any procedures for full mouth rehabilitation requiring appliances or restorations.
Any services provided for free by a county, government, municipality, or other agency.
Any procedures referred to another dental office.
There are NO refunds on your in-office savings plan.
Patients cannot use both dental insurance benefits and savings from the in-office savings plan – plan is for uninsured patients only.
If a patient elects not use any of the services, they cannot be transferred to another patient.
Any missed appointments or cancellations not made within 48 hours of the appointment may be charged a $25.00 fee per 30 minute appointment. Missed appointments or cancellations not made within 48 hours for treatment over $1000 will be charged 25% of the services that were to be rendered.
If Care Credit is used for financing treatment, all payment terms will be made to Care Credit and will be offered repayment over 6 months where approved. The initial fee is $319.00 for one individual and only $269.00 for each additional family member. If Care Credit is used for treatment, discounts will be reduced to 10% savings on periodontal treatment, 5% savings on general and restorative procedures, and 0% savings on major procedures: implants, implant restorations, and over the counter products.
Payment plans can be made upon request and depend on the total amount due and type of dental procedure. Patients using a payment plan option will have their savings offered, on our program, customized to fit their financial needs. For payment plans of more than 3 payments, we will require a credit card be placed on file. Any payment plans must be discussed between the patient and doctor.
The plan fee of $299.00 must be paid in full prior to initial visit.
If you have periodontal disease, a periodontal maintenance will be performed as a ‘simple’ cleaning but two cleanings will not be sufficient for your oral health care needs. Should you need more than two periodontal maintenance visits within a year, the plan benefits will apply to the first and third periodontal maintenance visits. Each additional periodontal maintenance visit will have a 20% discount on the UCR periodontal maintenance fee (or 10% for Care Credit users).
Procedures and products not eligible for discounts include: Nitrous, In-office prescriptions, sedation, water-piks, and electric toothbrushes.
The plan cannot be used for any previous treatment that has been completed.
Price of plan subject to change without notice.
In the case that the plan is not renewed before or at the one year date, there will be an additional $50.00 re-instatement fee.

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Please call us at (703) 962-4218 if you have any problems with the form.
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