PATIENT FORMS & INSURANCE

PATIENT FORMS

WE MADE IT
EASY FOR YOU!

We make it easier for you to fill out the Forms Online for appointments.

FILL OUT THE ONLINE FORM

IN-NETWORK INSURANCE

We accept most PPO and HMO insurance plans, including:

HMO insurances need a referral from a primary dental clinician.

INSURANCE FINANCIAL DISCLAIMER:*

Deductibles & Co-Payments are due at the time of service. Dental insurances have different stipulations with regards to coverage. We do our best to determine the co-payments patients are responsible for based on our knowledge of each insurance company. Reimbursements from the insurance companies are not always predictable, and are discussed with the patients if necessary.

●AETNA DHMO

●AETNA PPO

●Ameritas

●Assurant/DHA PPO

●Blue Shield PPO

●Blue Shield HMO

●Cigna PPO

●Delta Dental PPO

●Delta Dental Premier

●First Dental Health

●Healthnet HMO

●United Concordia PPO

●United HealthCare PPO

●Anthem Blue Cross PPO

●Anthem Blue Cross 7020

●Healthnet PPO

●Humana PPO

●Guardian PPO

●LA PHP (of Premier)

●Premier Access PPO

●Principal EPO/PPO

●UFCW Local 1442

●Dentegra

●United Concordia HMO

●Cigna HMO

●Guardian HMO

● SafeGuard HTML (Metlife HMO)

●Metlife (Metropolitan)/Tricare PPO

●DeltaCare USA (Delta Dental HMO)

●Blue Shield Federal Employee Program

●AETNA DHMO
●AETNA PPO
●Ameritas
●Assurant/DHA PPO
●Blue Shield PPO
●Blue Shield HMO
●Cigna PPO
●Delta Dental PPO
●Delta Dental Premier
●First Dental Health
●Healthnet HMO
●United Concordia PPO
●United HealthCare PPO
●Anthem Blue Cross PPO
●Anthem Blue Cross 7020
●Healthnet PPO
●Humana PPO
●Guardian PPO
●LA PHP (of Premier)
●Premier Access PPO
●Principal EPO/PPO
●UFCW Local 1442
●Dentegra
●United Concordia HMO
●Cigna HMO
●Guardian HMO
● SafeGuard HTML (Metlife HMO)
●Metlife (Metropolitan)/Tricare PPO
●DeltaCare USA (Delta Dental HMO)
●Blue Shield Federal Employee Program

FINANCIAL INFORMATION

We accept most PPO and HMO insurance plans, including:

Financing plans are available upon request, including dividing your share of costs into monthly payments. Please inquire with our staff for more information.