Financial Policy

Our mission is to offer our patients the finest periodontal care and provide exceptional, prompt customer service. An important part of the mission is
making the cost of optimal care as affordable and manageable as possible, which requires an understanding of your responsibilities.

  • We require TWO (2) business days to cancel or reschedule an appointment:
    • We begin preparing for your visit two days prior to your arrival, and time is reserved exclusively for
      you. Patients who cancel without adequate notice will be charged for their missed appointment.
      Routine cleanings will incur a charge of $50.00. Surgical and scaling and root planing appointments
      will be charged 40% of the total appointment fee.
  • Payment is due at the time services are rendered:
    • Should treatment require multiple appointments, you are required to pay the balance incurred at
      time of service. Should you choose to discontinue care before treatment is complete, you will
      receive a refund less the cost of care received. Any discounts for services are only good when the
      balance is paid in full at time of service. Cheyenne Periodontics will charge a non-refundable $25.00
      returned check fee.
  • We will bill your insurance benefits for payment:
    • Providing you choose to use insurance benefits for payment, your estimated patient responsibility
      must be paid at time of service. We will file a claim with your insurance carrier, you will be billed (or
      refunded) after we have received payment from your carrier.
  • You are responsible to know if a procedure is a covered benefit:
    • We pre-authorize surgical and scaling and root planing procedures, which gives an estimate of your
      financial responsibility. However, we must emphasize, you are responsible to know your benefit
      plan as well as payment for services regardless of how you choose to pay. Insurance is a form of
      payment, but not a guarantee that you will not incur out of pocket expenses.
  • We are not responsible for rejected claims, reduced benefits or non-covered services:
    • The terms of your benefit plan are outlined by your employer or the plan you’ve selected, not our
      office. If a claim is rejected, your insurance carrier requests additional information or delays paying
      your claim, we will take action on your behalf up to 90 days in an effort to secure payment.
      Following 90 days of attempts with your insurance company, the total amount of the claim will be
      due by you, the patient.
  • Patients with past due balances:
    • You will be required to pay the balance in full prior to receiving any further treatment. Any discounts
      offered will be reversed if the account is sent to an outside agency for collection. Scheduled
      appointments may be canceled if a balance is left unpaid or referred to a collection agency. If a
      promise to pay is not kept, payment will be collected prior to services rendered.

Payment Options

Option 1: Full Payment at Time of Service (cash, check and all major credit cards)

Option 2: Outside Financing (CareCredit) for those who prefer an extended payment plan

This is an interest free payment plan for up to 12 months for purchases in excess of $200. Should you choose to apply, you may do so by phone 1-800-677-0718 or online at If interested, please inquire with the front desk for a brochure with further details on CareCredit and any special offers they may be offering.