Rebecca J. De La Rosa, DDS, PC

We recommend that regular dental check-ups and cleanings begin at age 3. Regular brushing can begin with the arrival of the first tooth, with a child-sized toothbrush and a pea-sized dab of children’s toothpaste. Parents can set a good example by teaching their children to brush on their own between ages 6 and 7.

Patient Resources/Office Policy

New Patient Forms

 

Please read the following form

Please print and complete the following forms and bring to your appointment

 

Office Policies


Copayments

We accept all insurance plans, as well as Visa, MasterCard, and Discover. Since we believe in affordable, accessible dental care for everyone, we also offer qualified patients, CareCredit®, a convenient, low minimum monthly payment program.

Charges for our services are reasonable and competitive.  In most cases, our charges and insurance Usual and Customary (UCR) fees are the same.  Prior to your initial appointment, our front office team will contact your insurance company and obtain a general breakdown of benefits with general guidelines of coverage.  Calculated estimated copayments based on the information received from your insurance company will be collected at the end of your visit.

In the event your insurance company does not pay the previously estimated amount, it is the patient’s responsibility to remit the remaining balance upon receipt of statement.  Please remember you are responsible for fees charged by this office regardless of your insurance coverage.

 

Insurance Estimates

We accept all insurance plans.  However, for some insurance plans we are considered out-of-network.  For these plans, the insurance payment is based on the Usual and Customary (UCR) fees.  UCR fees are determined by your insurance company and your employer.  There is no regulation for determining these fees; therefore, they can vary widely from plan to plan.  In most cases, our charges and insurance Usual & Customary fees are the same.

 

Cancellations

Many dental offices double or triple book their schedule.  We do not do this.  We set aside time solely for each patient; this insures that each patient receives the attention and care they need. 

In the event that you need to reschedule or cancel an appointment, a minimum of 24 hour notice is required.  This notice allows us time to contact another patient in need of care.  If the minimum time requested is not given, a $20 fee will be applied to your account.

 

Patients in Treatment Rooms

Only patients receiving dental care are allowed in treatment rooms.  There are several reasons for this policy.  For health safety, Federal OSHA guidelines regarding airborne pathogens mandate clinicians and non-patients in a treatment room to wear gloves, goggles, and a mask.  Providing non-patients with protective accessories is cost prohibited.  In addition, our treatment rooms are designed to accommodate patients and clinicians not additional seating for non-patients. 

Young children are provided dental care unaccompanied by their parents.  This separation allows the child to focus on the instructions given by our clinical staff.  Our goal is to help children experience an educational, comfortable and enjoyable visit while maintaining quality of care.      

 

Cellular Phone Policy

The use of cellular phones is allowed in our reception area.  Patients are asked to turn off their cellular phone while receiving care in our treatment rooms.  If special accommodation is needed, our front office team will be happy to receive a message of importance during your appointment. 

 

Avon Family Dentistry

7318 East U.S. 36, Suite 100, Avon, IN 46123

Rebecca J. De La Rosa, DDS, PC

General & Cosmetic Dentistry

Contact

T 317-272-7715 | F 317-272-7719 | Email