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Financial Guidelines for Smile Frederick Orthodontics

We strive to provide the best possible care according to the

guidelines set forth by the American Association of Orthodontics.

These recommendations are to include, but not limited to:

*Oral examination/ Diagnostic Records

*Treatment Plan recommendations

*Excellent Orthodontic care




Appointments – 24 hours’ notice is required to cancel appointments.  Missed appointments and same day cancellations will be assessed a $50.00 fee, payable immediately.  We understand conflicts occur; however, the more notice given, the better chance we have to appoint another patient in need of care. 


All Patients – The office will allow 2 no show/ same day cancellations.  Any missed appointments thereafter, will be subject to a fee of $50.00 per appointment.  In order to complete treatment in a timely manner, it is essential to attend recommended  appointments for necessary adjustments.  After 3 consecutively missed appointments, either missed or non-scheduled);  the office will provide emergency/ maintenance appointments, only until treatment is discontinued.


Assignment of Benefits – The practice will accept assignment of benefits IF all pertinent information is provided prior to the appointment and the insurance company will accept assignment of benefits to the dentist.


Patients with Insurance – It is your responsibility to confirm your eligibility.  If at the time of service, you are not eligible for benefits, you will be responsible for all charges. IT IS YOUR RESPONSIBILITY TO KNOW YOUR OWN COVERAGE.   As a courtesy, we file your insurance claims.  Insurance companies do not guarantee any payment until they receive the claim, review it, and process it according to their specific policy terms.   In the event that your insurance company rejects payment or discontinues payment during the course of your orthodontic treatment, the balance will be transferred and your financial contract will need to be renegotiated to include any unpaid insurance balance.


Payments Methods – We accept cash (Initial Banding Fee only).  All monthly payments will be in the method of Auto Pay directly from your financial institution or credit/ debit card only.   Care Credit and 0% in office financing are also available.  The name OSI (OrthoSynetics, Inc.) will appear on your bank statement and not ‘Smile Frederick Orthodontics’.   All payments are due by the 15th of every month and are considered late after the 20th of the month.  A late fee of $25.00 will apply.


Smile Frederick Orthodontics

7360 Guilford Dr, suite 101

Frederick, MD  21704

Or call to pay by phone at 301-788-2522

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