New Patients

New Patient Forms
Acknowledgement of Notice of Privacy Practice
Financial Policy

At Jovita A. Barcena DMD Inc., your first appointment includes a thorough exam and gathering any information that our dentist must be aware of in order to provide care specifically to your oral health. We understand that all patients are different and require individualized care. 

Our Practice's Mission:

To fulfill our mission of providing quality dental care to you and your family, we are committed to:
  • Staying up to date with latest techniques and equipment.
  • Ensuring a comfortable, relaxing environment.
  • Exceeding your expectations with our professionalism.

What Every Patient Can Expect

At our practice, every patient can expect to be treated with prompt service at their specified appointment time. Our patients can also look forward to a comfortable experience. We understand that visiting a new dentist can be stressful, which is why our practice works to actively to accommodate all patients and alleviate any fears they may have about a new dentist or dentistry treatments. Familiarizing yourself with our practice, services, and our dentist is a great first step to creating a long term and comfortable experience with dentistry.

Financial Policies

Esthetic and restorative dentistry are excellent investments in an individual's well-being. We firmly believe that financial considerations should not be an obstacle to obtaining the treatment you desire. We are sensitive to the fact that each patient h a s different needs and have several payment options available so that treatment is accessible to everyone. All financial discussions and arrangements are kept strictly confidential.

PAYMENT OPTIONS:

You can choose from:

  • Visa/Mastercard/Discover/American Express Card
  • Cash
  • Check

We offer a 5% courtesy accounting adjustment to patients who fully pre-pay for their treatment before start of treatments that cost $500 or more.

Convenient Monthly Payment Plans from Care Credit

  • Allow you to pay your balance over time
  • No annual fees or pre-payment penalties
  • No interest payment plan available (Subject to Credit Approval)

Dr. Jovita A. Barcena, DMD requires payment prior to the beginning of your treatment. If you choose to discontinue care before treatment is completed, you will receive a refund but will be deducted on whatever the cost of care already received.

We also offer in-house financing for treatments:

  • $300-$500 (No interest) with 50% down payment and balance is divided into 2 to 3 payments.
  • Over $500 there will be a 1.5% interest on Unpaid Balance.
  • We charge $10 for late payments (Grace period on payment is 10 days after each due date).
DENTAL INSURANCE

For patients with dental insurance, as a courtesy we will try to bill your insurance for your dental treatment. Insurance companies now do not give our office all the necessary information needed. It is therefore the patient’s responsibility to be familiarized with his/her dental insurance plan and benefits.

However, if we do not receive payment from your insurance carrier within 90 days, you will be responsible for payment of your dental treatment and collection of your benefits directly from your insurance carrier.

Co-payments are required at the beginning of treatment.

Most PPO Insurance Companies and Medicare Advantage Plans are accepted.

Please note that we are NOT a provider of HMO, nor Dentical.

CANCELLATION OR NO SHOW POLICY
  • $50 cancellation fee for regular appointment without 24 hours notice from date/time of appointment.
  • $100 cancellation fee for major work like crown, bridges, and oral surgery.
RETURNED CHECK

Jovita A. Barcena, DMD charges $50 per returned check occurrence.

If you have questions, please do not hesitate to ask. We are here to help you get the dental treatment you want or need.