Financial Policy

Welcome to our Office 

We are happy you have selected Pine City Dental to serve your dental health needs. Our staff works together as a dedicated team, and has developed the following “Mission Statement”: 

It is the mission of our office to strive for, attain, and deliver the highest quality of dental care to our patients with integrity and compassion. We will provide a highly trained, ethical and professional staff. We will offer our patients treatment options to fit their personal needs. As a result we hope our patients are highly satisfied with their personalized care, and enjoy oral health with beautiful smiles for a lifetime. 

Office Hours

Our regular office hours are 8:00 A.M. to 4:30 P.M. Monday through Thursday. Our office is closed  Fridays, weekends, major holidays and at times when the doctor and staff are attending continuing education programs to keep abreast of the latest health care developments.  

Financial Policy and Fees 

We have established the following payment guidelines to reduce the paperwork involved in billing, while maintaining a superior level of professional care.

  1. Payment in full is expected and due on the day treatment is rendered.
  2. If you are covered under an insurance plan, the estimated portion that the insurance will not cover is expected and due on the day treatment is rendered.
  3. Payment can be made using Cash, Check, or your Visa/MasterCard/HSA/Flex card.
  4. Third party extended payment financing is available upon approval with Care Credit. 

If an account is not paid in full within 60 days of the date of service, the account will be evaluated by our financial team. Accounts outstanding more than 60 days will bear interest of 1.5% per month or 18% per annum, and may be subject to collection agency fees, legal fees, and other expenses incurred in the collection of your account.  Because dental laboratories require prompt payment from us, a down payment from you is necessary to offset our “upfront” expenses.  This down payment is to be paid on the day of the impression for extensive treatment. A fee of $25 is charged for returned checks, payable by cash or credit card.  This will be applied to your account in addition to the insufficient funds amount.                                                                                                        

Minor Children 

The responsibility of payment for services rendered to the child/children of divorced or separated parents rests with the parent who seeks treatment. Any court ordered judgment must be between the individuals involved, without including our facility. 


If you have insurance we will help you determine the coverage you have available. We ask that you assign your insurance benefits to us.  The balance will be arranged for you to pay as listed above.  Coverage varies from carrier to carrier, as does the percentile that each carrier uses to calculate its’ “usual and customary fees”.  Our fees may exceed the usual and customary definition of your particular insurance company.  It’s important to understand that professional care is provided for you and not to an insurance company.  Thus, the insurance company is responsible to the patient and the patient is responsible to our office for any balance not paid by the insurance.  We are well-versed in filing patient’s claims and handling questions.  We will help you in any way we can. 

Appointments and Cancellation Policy 

Patients are seen by appointment only. Please call in advance so that we may reserve a time for you.  The office telephone number is  320-629-2789.  We make every effort to be on time for our patients, and ask that you extend the same courtesy to us.  We ask that if you cannot make your appointment with us, to please call at least 24 hours in advance.  We may be able to use that time that was reserved for you in a way that could be very helpful to another patient.  Many have commented that it was an unexpected convenience to be able to complete dental treatment earlier that anticipated.  In cases of frequent broken appointments in which adequate notice was not given, we may be forced to charge for the reserved time.  We reserve the right to discontinue our relationship with you after 3 consecutive missed and/or short notice cancelled appointments.  

Emergency Care 

We reserve a limited amount of time each day so that emergency patients may be scheduled quickly. If you have a problem requiring emergency treatment, please call us as early in the day as possible.  Should an emergency occur after the office hours, and you are a patient of record,  you can call the main office number for instructions for reaching the doctor on call. 

The Recall Visit 

Upon completion of your dental treatment we will place you in our continuing care program and pre-schedule you for your Periodic Recall. These appointments are designed to prevent little problems from becoming big or expensive ones.  Preventive dentistry is the best and least expensive dentistry, but it is easily overlooked or postponed.  If you think you may be overdue for this important service, please check with us and we will verify it for you.  

It is our goal to make your visit to our clinic as convenient and comfortable as possible. We sincerely value your patronage.     

                                                                                                                                                                                                                 Revised Jan 2018