First Visit
Please assist us by providing the following information at the time of your consultation:
- Your referral slip and any X-rays if applicable.
- A list of medications you are presently taking.
- If you have medical or dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.
IMPORTANT: A parent or guardian must accompany all patients under 18 at the consultation visit.
Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e. diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are on any medication (i.e. heart medications, aspirin, anticoagulant therapy, etc.) or require medication prior to dental cleanings (i.e antibiotics, for pre-med.)
X-Rays
Financial Policy
Patient Billing
For your convenience we accept Visa, MasterCard, American Express, Discover, and CareCredit. 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 704-825-2808. 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 this must be done prior to the actual procedure.
Insurance Information
At Gaston Endodontics we make every effort to provide you with the finest care and the most convenient financial options. To accomplish this we work hand-in-hand with you to maximize your insurance reimbursement for covered procedures. If you have any problems or questions, please ask our staff. They are well informed and up-to-date. They can be reached by phone at 704-825-2808.
Please call if you have any questions or concerns regarding your initial visit. Please bring your insurance information with you to the consultation so that we can expedite reimbursement.