Dear Pastor,
This
dental practice is dedicated to honoring and serving the Lord Jesus Christ.
One way that we wish to serve Him is to offer to meet the dental needs of
those who are in the full-time ministry for our Lord.
We
have established a category of patient accounts called a "Pastoral
Account". This account is
offered to you and any of your children under the age of 18 who are living
within your household. We want you
and your family to be able to select your needed dental care with the same
counseling and recommendations provided to all our patients.
However, your account will be handled differently.
We will give pastors a 15 %
discount on dental services. Also upon your request we will donate 10% of
your payment to one of the following ministries of your choice: Focus
On The Family, Back To The Bible,
Camp Rock, KCMI,
Community Christian School
or KLOVE.
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There
is one exception to the above
policy. That exception is if you fill for
dental insurance. We will
freely complete all insurance claims for you.
However we are bound by
contractual law to have you pay your co-pay and deductible at the time services
are rendered according to your
insurance policy. These are the
policies established by your insurance company of which we are bound by law to
follow.
We
ask that you call and notify our office 48 hours before your scheduled time if
you need to change your appointment. This
time has been especially reserved for you.
However, due to misuse of the “Pastoral Account” appointments we must
enforce the following policies. Your
first missed appointment will be a grace or “OOP’s” as for all our
patients. Your second missed
appointment without notification will result in you choosing to give up
confirmed appointments and when you need dental services we will call you when
there is as opening. The third time
will result in forfeiting the “Pastoral Account” benefits and your account
will be considered a “Standard Account”.
You will then be responsible to pay for all services rendered at time of
service.
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It
has been and continues to be the policy of this office to freely meet needs
concerning relief of pain and/or infection for ANYONE in financial distress.
We encourage you to notify us of anyone in such need and have that person
tell our Patient Care Coordinator that pastor (your name) from (your church
name) referred them to our
practice.
Your
continuing input as to how we can best serve the needs of the Christian
community is earnestly solicited.
Pastoral Account:
1.
You will be given the same choices and quality of care and treatment
extended to all our patients.
2. At each
appointment you will be given an invoice indicating the
value of the dentistry received, given a 15% discount, and asked if we can file your insurance
claim for these services, if appropriate.
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3.
We ask all our patients that if
you need to change your appointment to please do so with 48 hour notice before
your appointment so we can offer that time to others in need.
Not following this policy results in:
