Effective Date: June 28, 2025

Last Updated: June 28, 2025

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Introduction

At Summit Smiles Dental, we are committed to providing exceptional dental care and maintaining transparent financial practices. This refund policy outlines the circumstances under which refunds may be issued and the process for requesting them.

General Refund Guidelines

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1. Eligibility for Refunds

Refunds may be considered in the following circumstances:

Patient-Initiated Refunds:

• Overpayment by patient or insurance company

• Duplicate payments or billing errors

• Cancellation of treatment before services are rendered

• Prepayment for services that cannot be completed due to medical contraindications

Insurance-Related Refunds:

• Insurance overpayments or coverage changes

• Employer termination resulting in retroactive coverage cancellation

• Coordination of benefits adjustments

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2. Non-Refundable Services

The following are generally not eligible for refunds:

• Completed dental services and procedures

• Consultation and examination fees when services were provided

• Laboratory fees for work already fabricated

• Emergency or urgent care services rendered

• Administrative fees and appointment deposits

• Services completed more than 30 days prior to refund request

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Refund Request Process

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3. How to Request a Refund

Step 1: Submit Written Request

• All refund requests must be submitted in writing

• Include patient name, date of service, amount requested, and reason for refund

• Provide supporting documentation (receipts, insurance statements, etc.)

Step 2: Review Process

• We will review your request within 5-7 business days

• Additional documentation may be requested

• Complex cases may require additional review time

Step 3: Decision and Processing

• Written notification of our decision will be provided

• Approved refunds will be processed within 10-14 business days

• Refunds will be issued to the original payment method when possible

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4. Timeframe for Requests

• Patient refund requests must be submitted within 30 days of payment or service date

• Insurance overpayment refunds will be processed according to contractual obligations

• No refund requests will be considered more than 12 months after the original payment date

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Refund Methods and Processing

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5. Payment Method Guidelines

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Credit Card Payments:

• Refunds processed to the original credit card

• May take 3-5 business days to appear on statement

Cash Payments:

• Refunds issued via business check

• Issued within 10-14 business days of approval

Insurance Payments:

• Direct refunds to insurance company when required

• Patient portion refunded according to original payment method

Financing Plans:

• Refunds processed according to financing company policies

• May be applied as credit toward remaining balance

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6. Partial Refunds

In cases of incomplete treatment:

• Laboratory fees and materials costs are non-refundable

• Clinical time and services rendered are non-refundable

• Only unearned portions of prepayments may be refunded

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Special Circumstances

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7. Prepaid Treatment Plans

For patients who prepay for treatment sequences:

• Refunds available for unrendered services

• Laboratory and material costs already incurred are non-refundable

• Partial refunds calculated based on completed vs. planned services

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8. Treatment Plan Changes

When treatment plans are modified:

• Overpayments will be credited toward future services or refunded upon request

• Treatment plan estimates are approximations; final costs may vary

• Patients will be notified of any significant cost changes before proceeding

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9. Disputed Services

For disputed service quality or satisfaction issues:

• We encourage open communication to resolve concerns

• Documentation review will be conducted

• Decisions will consider clinical standards and patient safety

• Professional liability insurance guidelines will be followed

Legal and Professional Considerations

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10. Release Documentation

When appropriate, refunds may require:

• Signed release forms to prevent future liability claims

• Documentation acknowledging treatment received

• Waiver of claims related to the refunded services

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11. Insurance Reporting

In accordance with professional standards:

• Certain refunds may require reporting to regulatory bodies

• Professional liability insurance carriers may be consulted

• Patient privacy will be maintained throughout the process

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Contact Information

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12. Questions and Concerns

For refund-related inquiries, please contact:

Summit Smiles Dental
5605 Richmond Ave
Dallas, TX 75206
Phone: (214) 824-2501
Email: office@summitsmilestx.com

Business Hours:
Monday - Thursday: 8:00 AM - 5:00 PM
Friday - Sunday: Closed

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13. Dispute Resolution

If you are unsatisfied with our refund decision:

• Request a meeting with practice management

• Written appeals may be submitted within 30 days

• External mediation services are available if needed

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Compliance and Updates

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14. Regulatory Compliance

Complies with:

• Texas State Board of Dental Examiners regulations

• American Dental Association guidelines

• Insurance industry standards

• HIPAA privacy requirements

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15. Policy Updates

This refund policy may be updated periodically to reflect:

• Changes in regulations or industry standards

• Updates to insurance requirements

• Practice policy improvements

• Patient feedback and concerns

Patients will be notified of significant policy changes through:

• Posted updates on our website

• Written notification during visits

• Email communication to active patients

Note: This refund policy should be reviewed by a qualified attorney familiar with Texas dental practice law and your professional liability insurance carrier before implementation. Individual circumstances may warrant exceptions to this policy at the discretion of practice management.