Patient Forms
WE ARE HAPPY TO ACCEPT NEW PATIENTS
Insurance Information
We are in-network with many insurance companies and will submit your claims to most others. It is important to remember that the policyholder is responsible for knowing and understanding their insurance information, but our Billing Specialists are available to assist. You can also contact your insurance company or your plan administrator for more information.
If you have questions regarding your dental insurance, please give our office a call at 608-222-6160.
We are in-network with the following:
- Delta Dental – Premier and PPO (Premier only for Ortho)
- Cigna- PPO only (both Pedo and Ortho)
- Metlife- PDP (Pedo Only)
- Humana (Pedo Only)
- Momentum (Pedo Only)
- ADP (Both Pedo and Ortho)
- Ameritas (Pedo only)
- Unum (Pedo Only)
- Colonial Life/ Colonial Voluntary Benefits (Pedo Only)
- Starmount (Pedo Only)
- AlwaysCare (Pedo Only)
Additional Insurance that we submit to (and are out-of-network):
- Aetna
- Alliance
- Assurant
- Auxiant
- Companion Life
- Corporate Benefit Services
- FMH
- GEHA
- Guardian Life
- Principal
- Physicians Plus Dental
- TeamCare
- UMR
- United Concordia
- United Healthcare Dental
- And more…
Financial Information
We accept cash, personal checks, Visa, MasterCard, Discover, and American Express. We also accept HSA cards as well as Flexible Spending cards. Care Credit is an additional financing option, with interest-free payments for up to 12 months, with credit approval.
Bills may be paid online at our secure site by clicking the ticket icon below, or you can call our office to make a credit or debit card payment. Statements are mailed monthly.
Payment is due at the time of service. We are always happy to work with you to find financial arrangements that are favorable to everyone. Please call our Billing Specialists if you have questions.
Click the logo for online bill pay services
*You will be redirected to a secured online site
Financial and Insurance Billing Specialists
We can be reached during office hours by calling
608-222-6160 or by email:
Dawn H– Pediatric Billing – Email
Dawn R – Pediatric Billing – Email
Shelley – Orthodontic Billing – Email
Julie – Orthodontic Billing – Email