Our Financial Information
I nsurances We Accept
Some of the insurance providers that we accept are:
- Ameritas
- Cigna
- Delta (most states)
- Met Life
- United Health Care
- Guardian
- GEHA
- NC Medicaid
- BCBS (Federal and State)
Financial Policy Information
- We gladly accept cash, checks, MasterCard, Visa and Discover. For your convenience, financing is available through a third party upon credit approval. Please inquire with one of our Patient Service representatives for details.
- There will be a $50 fee for any returned check
- Payment for fifty percent (50%) of patient responsibility (amount not covered by insurance) is expected at the time of scheduling of procedure.
- I understand that my insurance contract constitutes an agreement between the insurance company and me, and not between Dr. Cusumano and the insurance company. We file with the insurance company as a courtesy to our patients.
- I must provide the following information in order for Francis J. Cusumano, DDS, PA to accept insurance as payment: 1. Current dental insurance information and/or a current dental insurance ID card & picture ID 2. Payment in full of the following: any applicable copayment/coinsurance/deductible
- If my dental insurance cannot be verified or if I do not have insurance, I will pay in full with cash, check or credit card at the time of service.
- Pre-authorization may be required by your insurance provider and is not a guarantee of payment. Copayments are accepted for procedures if a pre-determination from your insurance carrier is on file, otherwise payment is expected in full.
- Failure of your insurance carrier to reimburse your account within thirty (30) days will result in our office billing you directly for any balance.
- The fees quoted you represent the fees of our surgeons only. You will receive a separate bill from any other medical providers participating in your care.
- It has been explained to me that during the course of surgery unforeseen conditions may be revealed which will necessitate extension of the original procedure or a different procedure. I authorize my doctor and his staff to perform such additional procedures as is necessary and desirable in the exercise of professional judgment. I do understand that additional charges may be incurred.