Financial Policy
Regarding your Dental Discount Plan
The DSI Dental Discount Plan Enrollment Period is 12 months from the Month of Initial Enrollment. This Dental Discount Plan requires the member to stay enrolled for 12 consecutive months. Failure to maintain DSI Plan membership during the total enrollment period will result in the direct billing of all dental treatment rendered by the contracted dental center to the member at the “Fee for Service” schedule of payments, less the total amount of funds contributed to the plan that was allocated to the contracted dental center. Copies of the dental fees associated with your treatment plan utilization during the time you are enrolled with DSI can be requested from your dental provider at no charge.
Your Dental Discount Plan is a contract between you and DSI. DSI is not meant to be a pay-all option but meant to be an aid. Some of the services provided under your Dental Discount Plan may be considered Non-Covered Benefit above their Usual and Customary Fee or based on as set Fee Schedule. Your benefits are dependent on how much your Dental Discount Plan covers. If you have any questions regarding the detail of your plan, we ask that you contact DSI.
Change or Cancellation/Termination
Please notify our office for any changes, so we may update our information. If you decide to terminate or cancel your Dental Discount Plan, you will be responsible for all the DSI charges at GentleCare Dental Clinic, from the start date and end date of your Dental Discount Plan.
Returned Checks
Should your account default in payment due to Insufficient Funds, you will be faced with a fee of $45.00 in addition to your monthly fee.
Late Fees and Interest Charge
Payment is due by the 1st week of every month. Failure to make payment within 30 days will be subject to a 2% finance charge. Any payments not made after the 45 day wait period will become immediately due in full. Accounts over 60 days past due will be subject to a monthly billing service charge. Accounts over 90 days will be sent to in house collections and you will be responsible for all additional interest fees, collection fees, processes and any potential attorney/ court fees.
