West Jordan, UT 84084

Mon - Thu 8:30 AM – 5:30PM

Financial Policy & Agreement

Thank you for choosing West Jordan Smiles for your family’s dental needs.   We are committed to providing you with affordable and excellent dental care.  Your trust is very important to us so our goal is to make sure you fully understand your treatment needs and financial responsibility before treatment begins.  We will make every effort to work with you to ensure that your dental needs can be met.


As a courtesy to you, we will help you process all of your dental insurance claims.  Please understand that we will provide an insurance estimate to you; however, it is not a guarantee that your insurance will pay exactly as estimated.  Insurance coverage is subject to limitations, exclusions, waiting periods, frequency, age restrictions, deductibles and maximums which are your responsibility.  Please contact your insurance company for details of your benefits. Your insurance company and your plan benefits ultimately determine the amount paid. We will do all we can to ensure your estimate is as accurate as possible.  Your estimated insurance benefit may differ due to a number of reasons, specifically related to your plan.

All Charges you incur are your responsibility, regardless of your insurance coverage.  We must emphasize that as your dental care provider, our relationship is with you, our patient, not with your insurance company.  Your insurance policy is a contract between you and your insurance company. Our office is not a party to that contract. If payment is not received or your claim is denied, you will be responsible for paying the full amount at that time.

We will cooperate fully with the regulations and requests of your insurance company that may assist in the claim being paid.  Our office will not, however, enter into a dispute with your insurance company. Insurance is not a guarantee of payment; it often does not cover all the costs involved in treatment.


Payment is expected at the time of service unless prior financial arrangements have been made.  We offer several options:

  1. Cash Discounts:
    1. For those without insurance, a 10% discount will be given for cash and checks and a 7% discount will be given for those paying with a credit card.
    2. Any check that is returned for any reason will be charged a $30.00 fee
  2. We accept Visa, Mastercard, and Discover and American Express.
  3. Term Loan:  By arrangements with CARECREDIT, we can offer patients upon approval, an interest-delayed  loan ( up to 12 months) with no down payment, no annual fee and no prepayment penalty. Ask for an application.
  4. Patients with insurance:  co-pays, deductibles, and/or portion not covered by insurance are due at the time of treatment.
  5. Patients without insurance:  all payments for dental services rendered are due at the time of service.  Please refer to Cash Discounts above and/or talk to our financial coordinator for any discounts that you may qualify for.


Our goal is to provide treatment in a timely manner.  Appointments are reserved exclusively for you.  We fully understand that life can be unpredictable and many times things come up unexpectedly.  Please help us service you better by keeping scheduled appointments. Your appointment reserves time for treatment with the doctors, hygienists, and assistants. Missing an appointment prevents others from receiving timely dental care. If you need to reschedule an appointment, be sure to notify us at least 48 business hours in advance. Missed appointments, and appointments cancelled less than 48 business hours in advance, are subject to a $35 fee.