Patient Information

Financial Arrangements

In order to aide in your financial planning, we would like to inform you of our financial policy. Our policy for the day of service is that payment is due when services are rendered. We accept cash or check, as well as Visa, MasterCard, Discover, or American Express. We also accept CareCredit payment plans.

This amount may vary depending on the patient’s portion with regard to insurance. However, if the patient holds no dental insurance they will need to be ready to pay the fee for the services. Our desire is to help you make wise decisions with regard to your oral health and give you the financial options to make that happen.

Insurance

You are responsible for payment regardless of any insurance company’s determination of usual and customary rates. Our charges are usual and customary for our area.

Your insurance policy is between you and your insurance company. We are not a party to that contract. We will file your insurance claim form for you as a courtesy. Please be prepared to pay your portion of your bill on the day you receive our services. If your insurance company has not paid your account in full within sixty (60) days, the balance will automatically become your responsibility. If a problem occurs with your claim you will be asked to contact your insurance company to help resolve the problem. You will be expected to pay your account in full regardless of your insurance company’s participation.

We are in network providers for Blue Cross Blue Shield of Kansas, Delta Dental PPO, and Metlife. We cannot file Medicare, Medicaid or state insurance.

At Park City Dental, we are committed to providing you and your family with the high-quality dentistry you expect and deserve. Our Loyalty Plan is a yearly membership plan designed to provide optimal care for patients without insurance plan restrictions.

This program was created specifically for our patients without dental benefits. Our Loyalty Plan has no deductibles, no maximums, no pre-approvals, or waiting periods. The membership fee is due in full the day you become a member. Once you are a member, you can immediately receive treatment. The membership plan also includes discounts for treatment services. All payments for treatment are due in full at the time of services.

Loyalty Plan

At Park City Dental, we are committed to providing you and your family with the high-quality dentistry you expect and deserve. Our Loyalty Plan is a yearly membership plan designed to provide optimal care for patients without insurance plan restrictions.

This program was created specifically for our patients without dental benefits. Our Loyalty Plan has no deductibles, no maximums, no pre-approvals, or waiting periods. The membership fee is due in full the day you become a member. Once you are a member, you can immediately receive treatment. The membership plan also includes discounts for treatment services. All payments for treatment are due in full at the time of services.

Adult Membership – $415

(13 and over)

  • 2 Cleanings
  • 2 Exams
  • 2 Emergency Visits *
  • X-rays
  • Sealants (up to age 19)
  • Fluoride (up to age 19)

Child Membership – $350

(12 and under)

  • 2 Cleanings
  • 2 Exams
  • 2 Emergency Visits *
  • X-rays
  • Sealants (up to age 19)
  • Fluoride (up to age 19)

**Emergency visits are within business hours. **

Treatment discounts include:

  • 40% discount – fillings, extractions, periodontal and endodontic services
  • 30% discount – crowns, bridges, dentures
  • 20% discount – partials, grafting, implants

Patient Forms

All of our patient forms are available in PDF format for download. Please print the necessary forms below and bring them with you to your first appointment.

Our Care Philosophy

At our practice, we cater to the needs of our patients by using advanced technology that helps us better diagnose and treat conditions and diseases. 

No-Judgement Zone

We listen to our patients to develop a personalized treatment plan that meets their individual needs. We achieve this by providing a neutral safe space, listening to your concerns, and customizing an individualized treatment plan. 

We believe in educating our patients on their treatment options.

QUALITY DENTAL CARE IN A PROFESSIONAL ENVIRONMENT

Your Comfort Is Our Number One Priority