Accessibility Tools

402 East Penn Drive   Enola PA, 17025

In order to enhance communication and promote understanding regarding this office’s financial and missed appointment policies, please read through the following information. It includes information about our policies regarding common situations that may occur including: 

No Show/Missed Appointments, Late Arrivals, Insurance, Minors/Dependents, Patient Payments, Payment Plans, Unfinished Treatments.


NO SHOW/MISSED APPOINTMENTS: We require 24 hours of notice for cancellation of appointments. If appropriate notice is not given, a charge of $40 may be assessed to the patient’s account. For appointments scheduled longer than 1 hour, the charge will increase, i.e., $90.00 for a two hour appointment, $200.00 for a 3 hour appointment. We reserve the right to dismiss any patient that misses multiple appointments. We understand that sometimes last minute cancellations are unavoidable. Individual circumstances may be discussed with the office manager and/or the dentist.

LATE ARRIVALS: If you are more than 15 minutes late for your appointment, we ask for your patience in seeing if we can rearrange our schedule to see you. If you think you will be more than 15 minutes late for your appointment, please call us immediately, so that we may advise you if we can rearrange our schedule to still see you, or if we need to reschedule you for a different day. If we must reschedule, a broken/missed appointment fee may be charged based on frequency of this situation and on the services that were being provided to you.

INSURANCE: We are happy to bill both your primary and secondary insurance carriers. Please understand that each patient is ultimately responsible for the cost of services rendered. Your insurance policy is a contract between you, your employer, and the insurance company. We are NOT a party to that contract. Our financial relationship is with you, not your insurance company.

(1.) You certify that the information you have provided regarding your insurance coverage is correct and authorize our office to verify insurance coverage and benefits allowed in accordance with your insurance plan’s policies.

(2.) You understand that you are responsible for knowing the terms and regulations of your insurance plan including limitations, exclusions, waiting periods, frequency, age restrictions, deductibles, and maximums.

(3.) All charges are your responsibility whether your insurance company pays or not. Not all services are covered benefits in all contracts.

(4.) If the insurance company does not pay your balance in full within 30 days, we will ask that you contact the carrier to help speed things up.

(5.) We will do our best to estimate insurance coverage and patient portions due. We will send pre-estimates for services over $500 at your request. An estimate will be given of the benefits that the insurance company is expected to pay. Remember that this is only an estimate and that the actual cost may vary. If the insurance company does not pay the full amount anticipated, the patient is responsible for the difference. Payment is expected within 10 days after the statement date.(Page 1 of 2)(Page 2 of 2)(6.) We will cooperate fully with the regulations and requests of your insurance company that may assist in the claim being paid. Our office will not, however, enter into a dispute with your insurance company over any claim.

(7.) If the insurance company does not pay in full within 60 days, we will require you to pay the balance due with cash, personal check, MasterCard, Discover, American Express or Visa.

MINORS/DEPENDENTS: Any parent/guardian bringing a minor or dependent to our office is legally responsible for payment of all services rendered to that person. In the case of divorced or separated parents, the parent accompanying the child is responsible for payment, without any exception. This office will not attempt to collect payment from a parent that is not present in the office at that visit. For unaccompanied minors or dependents, non-emergency treatment will not be done unless prior approval and financial arrangements have been made.

PATIENT PAYMENT: Payment is due at the time services are rendered unless otherwise arranged with our Office Manager. For larger cases, 50% of the patient portion is due at the start of treatment, including any deductible and the remaining 50% at the last appointment. We accept cash, checks, and all major credit cards. Returned checks will have an additional fee of $40.00 added to the amount of the returned check. Balances over 60 days will incur an interest charge of 1.5% per month. After 90 days the account will be considered delinquent and will go to a collection agency. I understand that if my account goes to a collection agency, that I will be responsible for all fees associated with the collection of my account. You agree, in order for us to service your account or to collect monies owed, Trask Family Dentistry and/or our agents may contact you by telephone at any telephone number associated with your account, including wireless numbers, which could result in charges to you. We may also contact you by sending text messages or emails, using any email address you provide to us. Methods of contact may include using prerecorded/artificial voice messages and/or use of automatic dialing devices, as applicable.

PAYMENT PLANS: We have made arrangements with the Care Credit Company to provide payment plans. This allows you to complete your dental work without delay and make relatively small monthly payments. Care credit is used for treatment over $300. Applications are available and approval can be determined within ten minutes. For your convenience you can also apply online at www.carecredit.com

REFUNDS FOR UNFINISHED TREATMENT: Please understand that if a patient decides to discontinue treatment after it has been started, a full refund will not be given. Individual circumstances may be discussed with the office manager and/or the dentist.

Notice of Privacy Practices

This notice is a legal requirement for our office to inform you of your rights as a patient of Trask Family Dentistry. It describes how health information that we gather about you may be used and disclosed and how you can get access to this information. Please review it carefully. The privacy of your health information is very important to us. Use the link below to read and download a copy of this notice for your records.