The frequency of payments to be made by the patient/responsible party is not related to the
frequency of the treatment visits, nor to the length of orthodontic treatment. The installment
payment plan is established only as a convenience to you.
As long as each and every payment is made as it comes due, no additional interest will be
charged. Additionally, no monthly statements will be sent to the patient/responsible party,
but a coupon book for payments may be issued upon request.
If a monthly payment becomes 27 days past due, Franklin Orthodontics, PLLC may charge a
$10.00 fee per month in which the account remains past due. In the event that Franklin
Orthodontics, PLLC must seek action for collection, patient/responsible party agrees to be
liable for all collection/attorney’s fees, the outstanding balance, a processing fee of 33% of
the outstanding balance, and all interest charges, late fees, and court costs.
The fee quoted above covers all routine orthodontic appliances and appointments. All general
dental procedures (i.e. extractions, cleanings, restorations, surgeries, composite buildups,
crowns, prosthetic appliances, etc.) are not included within the orthodontic fee. Any
complications extending treatment unnecessarily (poor patient cooperation, missed
appointments, lost or damaged appliances, excessive breakage, etc.) will require a
reevaluation of the initial fee and possibly necessitate additional charges to cover the
increased expenses for treatment. These changes will be discussed prior to being charged.
In the event treatment is terminated before completion of planned services, the balance due or
refund due will be calculated according to the work completed.