Oral Surgery Associates' employees have always respected each patient's right to privacy and confidentiality regarding the services we provide and the insurance claims we file for our patients.

We require, at the time of registration, the social security number of the person responsible for the payment of our charges and the social security number of the person who is responsible for all charges not covered by insurance.

We can file an insurance claim only if we have the insured party's social security number. Each insured party is required by their insurance contract to provide their social security number. Our insurance claim, filed on your behalf, will be accepted by the insurance company only if we use the insured party's social security number on the claim.

Failure or refusal to provide your social security number means…

• At the conclusion of each visit you must pay in full all charges for services provided during that visit.
• A written "Agreement" to pay our charges in a limited number of installments will not be available in this situation.
• We will provide you with a statement showing all our charges during that visit and your payment. You may then use this information to file your own insurance claim.

If you do not have insurance, then…

• You must still provide your social security number so we can complete the registration computer database process and be able to track your surgical and financial history with us.
• At the conclusion of each visit you must pay in full all charges for services provided during that visit.
• A written "Agreement" to pay our charges in a limited number of installments may be available in this situation.