Financial Information & Forms

We know that every family’s budget is unique, so we take a variety of payment methods and have financial options for both the insured and uninsured. If you have any questions related to finances, you can call or email our dental office, and one of our team members will be happy to help.

We accept the following payment methods:

  • Cash
  • Check
  • In-network insurance
  • FSAs and HSAs
  • AMEX, Discover, MasterCard, and Visa

Dental Insurance

We are happy to accept dental insurance at our practice. Our knowledgeable team helps take the stress out of using your insurance by filing and tracking your claims and looking for ways to maximize your benefits. Bella Vista Family Dental is in-network with:

  • Delta Dental Premier

Dental Membership Plan

Not everyone has dental insurance, but we think everyone still deserves access to affordable care. Our in-house dental membership plan is a great option for both individuals and families who don’t currently have dental coverage.

We have two plans available depending on your dental needs. When you enroll in either, you’ll receive certain procedures at no additional cost, as well as a significant discount on other treatments. Membership begins as soon as you sign up and lasts for the entire year!

Gold Plan

$360/Year
  • Covers yearly cleanings, x-rays, and exams
  • Includes a 15% discount on restorative services

Periodontal Plan

$495/Year
  • Covers two to four periodontal maintenance procedures along with necessary x-rays and exams
  • Includes a 15% discount on restorative services

Financing Options

We know that out-of-pocket dental costs can sometimes feel like a burden on your wallet. To help cover these costs more easily, Bella Vista Family Dental has two financing options available. We offer in-house payment plans, the terms of which one of our team members would be happy to discuss with you further. We also accept CareCredit, which allows you to pay off your dental expenses like you would a credit card with manageable monthly payments. You can easily apply for CareCredit online!

New Patient Forms

We kindly request that all new patient paperwork be filled out prior to your first visit.

Bella Vista Family Dental New Patient Forms

Note: These forms can be filled out on your computer if you have Adobe Reader or Acrobat; alternatively, they can be printed and filled out by hand. Please bring all completed forms to your first visit. Thank You.

Bella Vista Family Dental HIPAA Policy
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