Rena Bains, D.D.S.
 Periodontal & Implant Reconstruction & Laser Surgery
2301 Saint Pauls Way, Modesto, CA 95355  (209) 578-4153

   

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Our Practice

 Dr. Bains Procedures & Services Laser Dentistry Contact Us Dental Implants
    



Periodontics

Dental Implants

Anesthesia
 
Laser Surgery

Tissue & Bone
Regeneration
 
Preventive Care

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  

Fees & Payment Options

     

Treatment
    
Your recommended treatment is based solely on our professional opinion.  Treatment recommendations are not based on your dental benefit plan because it is not in your best interest.  It is our daily goal to provide our patients with quality periodontal care.  Part of this commitment is being sure you understand our fees and our flexible payment options.
* Patients needing financial assistance can discuss the various options available with our Treatment Coordinator.

Lynda
 Treatment Coordinator
img_forms.jpg (3089 bytes)
 
 small.gif (312 bytes) Patients covered by dental benefit packages; e.g. insurance, are encouraged to provide complete and accurate information about their dental plan when they complete our Patient Information form. Failure to complete the section regarding insurance may result in a delay in processing your claim. We will ask for...
diamond.gif (133 bytes) Employer Name
diamond.gif (133 bytes) Employee Name
diamond.gif (133 bytes)Employee Social Security Number
diamond.gif (133 bytes) Employee Date of Birth
diamond.gif (133 bytes) Name, address & phone of Insurance co.
                

small.gif (312 bytes)Please print out the following Forms.
Instructions: Click on the link below and print from the screen. 

Health History Form
 Responsible Party Form

Complete both forms in detail and bring them with you to the office.

 

Helpful Hint: For the best print minimize this screen and right click on your desktop screen. 
Select properties and settings. Set your settings to 800 by 600 pixels.
                        

Discounts Available
 
We offer cash discounts (5% for cash checks, and credit card payments) on treatment exceeding $500.00 when paid in full by the date of the treatment.   If you have a substantial co-payment, this can be a significant savings for you.   Your dental benefit provider will be billed only for the actual charges.  If you have paid in full, in advance, then any payments we receive from your benefit provider will be promptly reimbursed to you.
        

Zero Interest Loan
  
We can provide you with an application for a zero interest loan through Care Credit.  We accept MasterCard, Visa, and Discover credit cards.  And, of course, checks and cash are always welcomed.
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Filing Insurance Claims
         
We are happy to file the necessary forms to insure that you receive full benefits from your dental benefit provider.  However, we can make no guarantee of any estimated coverage.  Because the insurance policy is an agreement between you and your dental benefit provider, we ask that all patients be directly responsible for all charges.
     

Your Account
   
We strive to keep all of our patients informed.   This includes information as to the status of your account.  You will receive statements from our office as long as there is a balance on your account.  Toward the bottom of the statement, there will be information regarding what has been billed to your dental benefit provider.  The average insurance claim takes four to six weeks to be processed by your benefit provider.  Please contact your benefit provider if there are delays in the processing of your claims.  If charges remain unpaid after 90 days, administrative charges will start to incur.

  
Thank you for being our patient.
Please contact our staff if you have any questions.
(209) 578-4153