Our office hours are Monday 9-6, Tuesday through Thursday 8-5 and Friday 8-1 (administrative only). Appointments are usually scheduled at four (4) to eight (8) week intervals during treatment. The majority of these visits can be scheduled in the early morning or afternoon; however, appointments 1 hour or longer (putting braces on, taking braces off, impressions) need to be scheduled in the morning or early afternoon. We do understand that this may be inconvenient for some patients, but it does allow us to provide our best possible treatment and also to accommodate as many patients as possible during the afternoon hours.
It is the patient’s responsibility to make timely follow-up appointments. These can be scheduled after your visit, and are therefore, scheduled in advance. This will help to ensure that you can choose times/days that will work for you or give you ample notice to make arrangements. If you wait until the week before to attempt to schedule your followup visit you probably will not be able to get your most ideal time slot. Your appointment is reserved especially for you, and so we do require 24 hours notice to cancel. If you are 10 minutes late for your appointment please understand that we will likely need to reschedule your appointment in order to prevent inconvenience to the rest of our patients. Repeated missed appointments or last-minute cancellations may result in rescheduling fees.
As a courtesy to you we confirm your appointment 1-2 days prior, but please do not depend on this, since messages can be accidentally erased or overlooked.
We will always do our best to provide the absolute best orthodontic treatment for our patients, because we care. In return, we expect excellent treatment cooperation. This common goal for doctor and patient is what results in superior orthodontics. Below you will find a list of our expectations for all of our patients and/or parents:
At the least, poor compliance will extend treatment time, and at the most, it may even prevent us from completing your treatment at all. In these extreme cases we will be obligated to terminate active treatment.
When treatment is initiated we will draw up a financial agreement (contract), so that the terms of payment are clear. We offer a 5% courtesy for payment in full, or we can finance over the anticipated length of treatment with monthly payments. Payments are accepted in the form of cash, personal check, and credit card (Visa, Mastercard, Discover, American Express). Please be aware that there is a $40 charge for returned checks, and multiple instances may result in our accepting cash-only payments.
A monthly payment is a convenient way to spread out the cost of orthodontic treatment and is not related to treatment progress or appointments; therefore, payment is still collected even if there is no appointment during the month. For your convenience we do offer an autopay program, so that you will never miss a payment and avoid annoying late fees. Below is further information about our payment plans:
If you transfer or move during the course of treatment your account will be prorated, and the account will be settled prior to sending your records to your new orthodontist.
Once we verify and assign your orthodontic insurance benefit, an insurance ledger is established with the expected amount of insurance benefits. We will then be responsible to file your periodic insurance claims, accept payment and apply this to your account.
Please be aware that many insurances do not pay your benefit in a lump sum, rather they send payment over the course of treatment. If the patient’s benefit decreases, changes or terminates, the unpaid balance is transferred back into the patient’s ledger and will be the responsibility of the patient.
I hereby authorize insurance payment directly to Franklin Orthodontics, PLLC, otherwise payable to me. I understand that I am responsible for all costs of orthodontic treatment. I hereby authorize this orthodontic office to release all information necessary to secure payment of benefits. I authorize the use of this signature on all my insurance submissions, whether manual or electronic.
We love to celebrate the exciting moments of orthodontic treatment with our patients! This may include social media posts and photographs at special times, such as braces on or finishing treatment. If you would like to provide consent for these activities please sign below.
I have read the above document and understand the policies of Franklin Orthodontics, PLLC.
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
You have the right to:
You have some choices in the way that we use and share information as we:
We may use and share your information as we:
When it comes to your health information, you have certain rights.This section explains your rights and some of our responsibilities to help you.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
How do we typically use or share your health information?We typically use or share your health information in the following ways.
How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.
Effective date: 7/21/2020
