Patient Terms & Conditions
I. Parties. The following is an agreement between Provider or Provider(s) Corp. (“Provider or Provider(s)”) and you, a person seeking medical or dental treatment from provider (“Client” or “You”).
II. Patient Financing. Provider or Provider(s) provides patient financing to make the process and finances simpler and easier for Client. If you feel particular financial constraint at any given moment in time, the first step is to reach out to Provider or Provider(s) to see how we might better assist you.
III. Provider or Provider(s). This is defined as the person, entity, or company providing medical or dental services for Client who is enrolled in Patient Financing by Provider or Provider(s).
IV. Patient Financing Terms. The payment terms that will apply to this Agreement will be specifically enumerated and agreed to by you in the form you fill out when you agree to obtain Patient Financing from Provider or Provider(s).
Those terms are hereby incorporated into this Agreement.
I. Enrollment Fee. Immediately upon enrolling any patient in any Provider or Provider(s) patient financing program, Client will be charged one-time Enrollment Fee as specified in Schedule A along with the down payment as determined by the Provider(s). This fee is non-refundable.
II. Contingent Enrollment. Enrollment in any Provider or Provider(s) dental program is contingent upon successful debit of both the Enrollment Fee and first month’s payment.
Late Payments, Fees and Recover
I. Recurring Payment Fee: Client will be charged a flat fee as specified in Scheduled A with 10% of the payment on each recurring payment.
II. Late Fee. If Client fails to make a payment within the number of days specified by Doctor of when it is due, Client will be charged a Late Fee as specified in Schedule A for each instance of late payment. Client will be charged an additional collections fee(of balance owed) added at 60 days or the maximum amount allowable under applicable state and Federal law.
III. Attorney(s)’s Fees. If Client fails to make a payment within 60 days of when it is due, Client will be responsible for paying for all of Provider or Provider(s)’s reasonable attorney fees required to collect all outstanding amounts from Client.
IV. Overdue Fees. In case any patient has missed their payment or the account is in the overdue state, the payment will be automatically deducted as soon as the money is available in their bank account
Cancellation Policy – Monthly Payment Guarantee
Practice agrees not to sell or assign their Denefits accounts receivables to a third party. This action by the client practice will result in Denefits cancelling the monthly payment guarantee and/or cancelling the practice’s account with Denefits.
Termination and Cancellation
I. Termination. Only Provider may cancel the patient financing program. Once enrolled in the program, Client is responsible for making all payments in accordance with the other provisions of this Agreement.
II. Refunds. Provider or Provider(s) will not provide any refunds or return money once it has approved a Client. Any decision to refund money must be made by Provider as per the mutually agreed terms with Provider or Provider(s).
Provider or Provider(s)’s fees are non-refundable.
I. Means of Communication. By signing this Agreement, you consent to receive communications from Provider or Provider(s) by phone or email.
II. Assignability. Provider or Provider(s) may assign this Agreement to another party at any time. Client’s responsibilities are non-transferable and non-assignable absent written consent from Provider or Provider(s).
III. Credit Check. Provider or Provider(s) will not check your credit as part of this agreement.
IV. Credit Reporting. Provider or Provider(s) may report payment activities to credit bureaus as a non-debt recurring payment to help Client build credit. Provider or Provider(s) may also report defaulted debt to credit bureaus after payment is 45 days or more past due.
V. Governing Law. This Agreement and any matters hereunder shall be governed by and construed in accordance with the laws of state of California, excluding its conflict of law rules. Client hereto hereby consent to the exclusive jurisdiction and venue of the courts of state of California with respect to the resolution of any suit, action or proceeding hereunder.
VI. Severability. If one or more provisions of this Agreement are held to be unenforceable under applicable law, the parties agree to renegotiate such provision in good faith. In the event that the parties cannot reach a mutually agreeable and enforceable replacement for such provision, then (a) such provision shall be excluded from this Agreement, (b) the balance of the Agreement shall be interpreted as if such provision were so excluded and (c) the balance of the Agreement shall be enforceable in accordance with its terms.
VII. No Waiver. The failure to exercise or enforce or delay in exercising or enforcing any right or remedy provided by this Agreement or by law shall not constitute a waiver of the right or remedy or a waiver of other rights or remedies and the single or partial exercise or enforcement of any right or remedy provided by this Agreement or by law shall not preclude or restrict the further exercise or enforcement of any such right or remedy.
1. Provider Check Processing Fee: USD $10.00
2. Patient Enrollment Fee: USD $30
3. Guaranteed Payments Fee for Provider: Free
4. Late Fee: $25