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Nelson G. Woo, D.M.D.

 

Patient Information

Office Financial Policy

If we ONLY provide Endodontic Evaluation (Consultation without treatment same day):

This consists of an examination and testing, discussing the likelihood of maintaining the tooth and treatment options available to you.  In some cases, the doctor may recommend a CBCT scan to assist in visualizing details of treatment and pulpal anatomy.  This is NOT a covered benefit by dental insurance.  The fee for a CBCT scan is $75. Our consultation fee is $138. 

WE ARE ONLY IN NETWORK PROVIDERS FOR CIGNA PPO AND DELTA DENTAL PPO/PREMIER (WE ARE CONSIDERED OUT OF NETWORK WITH THE CIGNA PPO ADVANTAGE PLAN). 

If we provide Treatment:

Payment is due in full at the time of service.

We will file your dental claim on your behalf.  Depending on your dental insurance claim processing, payment should be made directly to you.  In the instance payment is made to Woo Endodontics, we will notify you of such and refunds will be given in the same form in which the original payment was made.

 

 
 

 

 

 

 Patient Signature                                                                                                                                            

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 Parent/Guardian Signature                                                                                                                        Date