Logo, Rock C. Chapman DDS, Inc. - Cosmetic Dentistry

591 North 13th Avenue, Suite 4, Upland, CA 91786
Smiling Family

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To Our Patients

Welcome to our practice. Enclosed is an appointment card for dental examination date. Please verify your scheduled appointment date and time.

We view our relationship with our patients with a deep sense of responsibility. We appreciate the trust our patients have for our professional skills. Our primary concern is to provide quality care, with as much comfort as possible.

When we welcome a new patient to the practice, we also welcome any questions you may have about office policies, insurance, and of course, fees. Let's anticipate you have questions about financial arrangements.

We work very hard to control the cost of dental care. It's part of our philosophy that quality care should be available to everyone. Our first rule of thumb: before any work is performed, we'll sit down together and go over our estimate of charges in every detail.

Insurance makes life easier. We'll help fill out your claim forms and answer any questions you have. Each policy is different, but in general, insurance usually covers about 70% of simple care and 50% of major work. Pre-authorization for major work will tell you the amount of your obligation ahead of time (no one likes these kinds of surprises). This way you pay only the estimated percentage of your total bill, that portion not covered by insurance.

When payment from your insurance company is received and applied to your account, any balance due will be billed to you, and any overpayment is refunded to you.

As a member with insurance benefits, you as patient, pay for services rendered according to the list of surcharges set by your program. Fee for services, are paid at the time services are rendered.

In the event of two insurance coverage's:

  • The prime carrier for the husband is his insurance.
  • The prime carrier for the wife is her insurance.
  • The benefits for the children are determined by the date of birth of the parents known as the birthday rule.

By utilizing both insurance's you may still have a remaining balance.

For our patients without insurance, we ask that you pay for services on the day they are completed. If this is impossible for you, we can work out alternative financial arrangements that suit us both. The way we see it, there's always a way to get the help you need.

If you have any questions, please ask one of the dental staff members. For your convenience, fees are payable as follows:

Cash • Checks • Visa, MasterCard, & Discover • Care Credit (Dr. Chapman's plan) Ask Us!

In consideration of the many patients awaiting treatment, appointments missed without prior notification of one full working day (24 Hours) will result in a charge of $35.00.

Please let us know if you have any questions.

Sincerely,
Dr. Rock C. Chapman, D.D.S.