Financial Policy
At Dr. Horri Aesthetic Reconstructive Dentistry, we believe that financial arrangements should be clear and straightforward. Treatment recommendations and anticipated fees will be discussed with you in advance so that you can make informed decisions about your care.
Payment for Services
Dr. Horri Aesthetic Reconstructive Dentistry is a fee-for-service practice. Payment is due in full at the time consultation, diagnostic, or treatment services are provided.
We accept personal checks and major credit cards, including eligible FSA cards.
Dental Insurance
We are an out-of-network provider for all dental insurance plans. As a courtesy, we will submit your dental insurance claims on your behalf using the appropriate diagnostic and treatment codes.
When necessary, we will also provide supporting documentation, including clinical records, radiographs, treatment narratives, letters of medical necessity, and requests for preauthorization or predetermination.
Your insurance carrier determines whether a service is covered and the amount, if any, that may be reimbursed under your individual plan. Insurance benefits are an agreement between you and your insurance carrier and do not alter your financial responsibility to our practice.
Payment remains due in full at the time of service, regardless of the amount or timing of any anticipated insurance reimbursement. Any estimate or predetermination provided by an insurance carrier is not a guarantee of payment.
Prepayment for Custom Treatment
Full prepayment is required for:
Cosmetic treatment
Orthodontic aligners
Oral appliances
Restorations and other services involving custom laboratory work
Because these treatments and appliances are designed and fabricated specifically for you, laboratory orders will be initiated after payment and all necessary authorizations have been received.
Credit Card Authorization
A valid credit card may be required to reserve certain appointments or authorize payment for treatment involving custom laboratory work.
Credit card information is collected separately through our secure Credit Card Authorization Form. The card may be charged only for amounts authorized by you, including treatment fees identified in your personalized statement and any applicable cancellation or missed-appointment fees described below.
Appointment Cancellation Policy
We reserve a limited number of appointments and dedicate each appointment exclusively to the individual patient. We therefore require a minimum of 48 hours’ notice to cancel or reschedule an appointment.
Cancellations or rescheduling requests received less than 48 hours before the scheduled appointment are subject to a $150 cancellation fee.
Missed appointments without prior notice are subject to a $250 no-show fee.
Questions
We are happy to answer questions regarding treatment fees, payment arrangements, insurance documentation, or our appointment policies.
Please contact our office before your appointment if you need additional information.
Dr. Horri Aesthetic Reconstructive Dentistry
45 Rockefeller Plaza, Suite 1857
New York, NY 10111
T:(212) 586-0410 | SMS: (917) 324-0062
info@maryamhorri-dmd.com
