Ackerman and Towson Dentistry

Brentwood Family Dentists | Dentist in Brentwood | Brentwood Ca Dentist

5 Star Reviews!
Kevin Ackerman, DDS, BS & Eric Towson, DDS, BS
Ackerman & Towson Family Dentistry
925-684-7722
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      • Dr. Kevin Ackerman, DDS, BS
      • Dr. Eric Towson, DDS, BS
      • Dr. Vincent Locascio, DMD, BS
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Patient Information Form

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  • Dental Benefit Plan Information

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  • Patient Responsibilities: We are committed to providing you with the best possible care and helping you achieve your optimum oral health. Toward these goals, we would like to explain your financial and scheduling responsibilities.

    Payment: Payment is due at the time services are rendered. Financial arrangements are discussed during the initial visit and a financial agreement is completed in advance of performing any treatment with our practice. We accept the following forms of payment: Cash, Check, Credit Card (MasterCard, Visa, Amex & Discover).

    Dental Benefit Plans: Your dental benefit is a contract between you or your employer and the dental benefit plan. Benefits and payments received are based on the terms of the contract negotiated between you and your employer and the plan. We are happy to help our patients with dental benefit plans to understand and maximize their coverage.

    If we are a contracted provider with your plan, you are responsible only for your portion of the approved fee as determined by your plan. We are required to collect the patient's portion (deductible, co-insurance, copay, or any other amount not covered by the dental benefit plan) in full at time of service. If our estimate of your portion is less than the amount determined by your plan, the amount billed to you will be adjusted to reflect this.

    If we are not a contracted provider with your dental benefit plan, it is the patient's responsibility to verify with the plan whether the plan allows patients to receive reimbursement services form out-of-network providers. If you plan allows reimbursement for services from out-of-network providers, our practice can file the claim with your plan and receive reimbursement directly from the plan if you "assign benefits" to us. In this circumstance, you are responsible and will be billed for any unpaid balance for services rendered upon receipt of payment from the plan to our practice, even if that amount is different from our estimated patient portion of the bill. If you choose to not "assign benefits" to our practice, you are responsible for filing claims and obtaining reimbursement directly from your dental benefit plan and will be responsible for payment to our practice before or at the time of service.

    Scheduling of Appointments: We reserve the doctor and hygienist's time on the schedule for each patient procedure and are diligent about being on-time. Because of this courtesy, when a patient cancels an appointment, it impacts the overall quality of the service we are able to provide. To maintain the utmost service and care, we do require a 48 hour notice to reschedule and appointment. With less than 48 hour notice, a fee may be required to reserve the time again. To serve all our patients in a timely manner, we may need to reschedule an appointment if a patient is more than fifteen minutes late or more arriving to our practice. To reschedule an appointment due to late arrival, a fee may be required to reserve the appointment time again.

    Unencrypted email is not a secure form of communication. There is some risk that any individually identifiable health information and other sensitive or confidential information that may be combined in such email may be misdirected, disclosed to or intercepted by, unauthorized theird parties. However, you may consent to receive email from us regarding your treatment. We will use the minimum necessary amount of protected health information in any communication. Our first email to you will verify the address you provide.

  • Confidential Health History

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  • This information will not be released unless specifically authorized by patient.
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  • Final Section for All Patients

Office Information

Ackerman & Towson Dentistry
100 Cortona Way Suite 200
Brentwood CA 94513
925-684-7722

OFFICE HOURS

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
8am to 5pm
7am to 4pm
11am to 7pm
9am to 6pm
8am to 5pm
8am to 1pm

Yelp Reviews

Dental Services

Preventive (Oral Disease Prevention)
Cosmetic (Esthetic Treatments)
Restorative (Repairing Teeth)
Periodontics (Gum Treatment)
Orthodontics (Braces)
Dental Implants
Dental Implant Information from AAID
invisalign

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