Payment and Financial Policy

In order to help maintain a good relationship with our patients, Associates in Dentistry – Charles L. Kincaid DDS PA has adopted a written financial policy. The purpose of this policy is to eliminate the confusion or misunderstanding concerning financial agreements offered by our office. Our office communicates this policy to each patient.

For our patients with insurance benefits, including State Funded Programs (KANCARE) please note that we are happy to bill your insurance carrier as a courtesy; the insurance contract exists between the carrier (your insurance) and the insured (you). We will accept the insurance assignment, but can not guarantee payment of benefits. Any questions regarding your benefits should be directed to your insurance carrier.

Our practice depends upon reimbursement from the patients for the costs incurred in their dental care and financial responsibility on their part.

-          Payment at time of service is required. The patient is required to pay the estimated portion of their bill that the insurance will not cover when treatment is rendered. We accept Visa, MasterCard, Discover, AMEX, CareCredit, Money Orders, Checks and Cash. If the patient does not have dental insurance, the patient is responsible for payment in full at time of service.

-          A statement of services rendered will be mailed at the beginning of each month. Receipt of payment is required within the time frame given in the statement (Due Date). If payments are needed, these need to be arranged before receiving any treatment, and it’s your responsibility to arrange these with us prior dental services are received. For payment agreements only CareCredit is available. Prior application and approval is required.

-          While the staff will make the best attempt to get accurate benefit information, any balance due after insurance pays is the patient’s responsibility. A late fee of 1.5% per month will be assessed and will appear on any subsequent statements. The annual percentage rate is 18%.

-          A $35.00 charge will be billed to the patients account for any returned check by the bank for any reason not paid.

-          All accounts unpaid after 90 days from the time of service are considered delinquent. Delinquent accounts will be sent to a collection agency and reported to the Credit Bureau. Collection and legal fee as will be added to your account. If your account was paid after collection activity, you may return to have services to our office. However if the account is sent for a second time to a collection agency, Associates in Dentistry - Charles L. Kincaid DDS PA will release your records for you to take to another dental office of your choice, after the balance is paid in full. We will not release any records if your account is undergoing collection activity.

If you would like more information about this policy, please contact our office.

Return Policy

A patient may discontinue treatment and ask for a refund from Associates in Dentistry - Charles L. Kincaid DDS PA at any time. We will refund any amount paid for treatment that they did not receive.

Refunds will be mailed or transmitted within thirty (30) days after Associates in Dentistry - Charles L. Kincaid DDS PA receives your written request. Refunds will be made in the same manner as the original payment, except cash. Payments in cash will be refunded by check.

We encourage you to read our policies and disclaimers before making a payment through our site. By making a payment you ackowledger that you have read and agree to the Return Policy mentioned above.

For additional information, please contact our Insurance and Billing office.




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Associates in Dentistry - Charles L. Kincaid DDS PA.
306 E 23rd St. Lawrence, KS
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