Office Membership Plan Terms Rules, Limitations, and Exclusions

Rules, Limitations, and Exclusions

1. This is a membership plan that offers discounted treatment; it is NOT a form of insurance.
2. This membership plan is only valid at Springs Family Dental, 1935 N Union Blvd, Colorado Springs, CO 80909. Services performed outside the office are not covered.
3. Monthly memberships are paid in advance monthly, on the first day of each month, on a month-by-month basis, via automatic credit/debit payment. Enrollment in automatic payment is required.
4. Monthly memberships require a minimum 12-month contract - early cancellation will immediately result in additional fees equaling the remaining months of the contract. 
5. In the event of a declined payment, the member's account will be immediately suspended, pending the member updating their payment information and their membership dues paid in full.
6. A missed monthly payment will terminate the membership plan and could result in early cancellation fees.
7. Members that wish to cancel their plan must submit a cancellation form prior to the 1st of the month. Memberships cannot be canceled by phone or email.
8. Early cancellation (less than 12 consecutive months) will result in the loss of previously discounted treatment and billing of the remaining balance.
9. Monthly payments may change and you will be provided written notice prior to the billing period.
10. Members CAN NOT have any other type of dental insurance/coverage. Obtaining other coverage while a member of "Springs Smiles" will immediately result in the termination of the membership plan. Previously paid fees will not be refunded.
11. All fees for services provided must be paid in full at the time of service unless other arrangements have been made prior to service.
12. Periodontal patients MUST sign up for the "Periodontal Plan" and are not eligible for the "Adult Plan." Patients who receive periodontal treatment while on the "Adult Plan" will be allowed to finish their current plan, but will be required to switch to the "Periodontal Plan" upon completion.
13. Any additional cleanings, exams, or x-rays over the allowed benefit are provided at our usual fees minus the 15% discount. CBCTs are not included.
14. Scaling and root planing is not considered a cleaning and is provided at our usual fees minus a 15% discount.
15. Patients who have not previously had a comprehensive exam must complete one before entering a plan. 
16. Members are responsible for receiving treatment within the allotted timeframe.  Unused benefits will not be refunded.
17. Failure to show or cancellation of a scheduled cleaning appointment without the required 48-hour notice will count as one of your cleaning occurrences and cannot be made up.
18. Products such as toothpaste, toothbrushes, rinses, etcetera are not included.
19. Rules, limitations, and exclusions are subject to change without notice.