Section I: Patient Code of Conduct

To maintain a professional environment for our patients and team, all patients and their companions must adhere to the following standards:

• Zero Tolerance for Abuse: We maintain a zero-tolerance policy for aggressive, threatening, or abusive behavior. This includes yelling, profanity, or derogatory remarks toward our surgeons, staff, or other patients.
• Treatment & Appointment Compliance: Compliance with scheduled appointments and strict adherence to pre-operative and post-operative instructions is crucial to maintaining a professional doctor-patient relationship. Failure to comply with clinical directives or missing appointments can seriously compromise your health, safety, and recovery, and may result in dismissal from our practice necessitating a referral to another office.
• Media Prohibition: To ensure HIPAA compliance and protect staff and patient privacy, cameras, cell phone cameras, and video/audio recording devices are strictly prohibited in the waiting room, consultation rooms, and surgical suites. Unauthorized recording is strictly forbidden.

Section II: Financial & Insurance Transparency

Because oral and maxillofacial surgery frequently involves complex overlaps between medical and dental insurance, we require all patients to understand our financial policies.

• Coordination of Benefits & Practice Advocacy: Procedures may fall under dental insurance, medical insurance, or both. Every carrier dictates strict Coordination of Benefits (COB) rules determining which policy is billed first. Apex Oral Surgery does not dictate these rules. As an in-network provider for certain plans, our compensation is capped at negotiated rates. We receive the exact same fee whether your insurance covers the procedure or you pay out-of-pocket; therefore, our team is highly motivated to advocate for you and submit claims meticulously to help secure coverage, and keep our clients happy. However, we cannot force an insurance carrier to pay a claim they deem uncovered.
• Good-Faith Estimates & Patient Responsibility: We will provide an estimate of your out-of-pocket costs prior to surgery based only on preliminary information from your carrier. This is not a guarantee of payment. Your insurance policy is a contract between you, your employer, and the carrier; Apex Oral Surgery is not a party to that contract. You are ultimately financially responsible for all charges incurred, regardless of arbitrary downgrades in service codes, unexpected claim denials, or depletion of yearly benefits.
• The 3-Month Settlement Window: We will do our best to settle claims with your insurance company. However, all patient account balances must be settled within 120 days of the date services were rendered, regardless of whether your claim is in progress, pended, or finalized. After 90 days, the balance will be charged to your credit card on file, and it becomes your responsibility to pursue further payment from your insurance company. Any insurance reimbursements paid to us after your bill is settled will be remitted to you within 30 days.
• Medical Insurance, Medicare & Medicaid: Apex Oral Surgery is out-of-network with all medical plans and does not participate with Medicare, Medicaid, or state-funded plans. These plans will not pay for any portion of our services, and we cannot submit claims to them. Patients are responsible for the full cost of treatment as determined by our regular fee schedule. We can provide you with a claim to submit to your medical insurance for your own reimbursement, but reimbursement is never guaranteed.

Section III: Appointment, Payment & Delinquency Policies

• Payment Due at Service: Initial consultations, exams, X-rays, and surgery visits are not complimentary. These are billable services, and payment/co-pays/first month's payment towards a payment plan/etc. are due at the time of service. Biopsy appointments are rarely covered by dental insurance and are billed directly by our office. (Note: Lab/pathology fees are billed separately by the examining lab and are not the responsibility of our office).
• Credit Card Authorization: You authorize Apex Oral Surgery to keep your credit card information on file to charge any outstanding balances, including applicable service fees, up to the contractual rate. This authorization remains in effect until the balance is paid in full.
• Direct-to-Patient Insurance Payments: Occasionally, medical or dental insurance carriers will send reimbursement checks directly to the patient rather than to our office. By signing this agreement, you acknowledge that these funds are meant to cover the cost of your care at Apex Oral Surgery. If you receive a check from your insurance company for services rendered by our office, you agree to endorse the check (write "Pay to the order of Apex Oral Surgery" and sign your name on the back) and deliver it to our office within seven (7) days of receipt. If the endorsed check or equivalent payment is not received within this timeframe, you authorize our office to automatically charge your credit card on file for the full outstanding balance associated with that claim.
• Payment Methods & Surcharges: We accept cash, check, debit, and credit card forms of payment. Monthly in-house payment plans for up to 4 months are available for account balances over $750 as long as a credit card is left on file. A $35.00 fee applies for any returned/bounced checks, or declined credit/debit transactions for monthly payment plans.
• Missed Appointments & Late Cancellations: Arriving more than 15 minutes late, failing to appear, or canceling with less than 24 hours’ notice (by phone or online) will result in a fee that cannot be billed to insurance. The fee is $100 for consults/office visits, and $350 for surgery appointments (regardless of the estimated cost of the surgery).
• Delinquent Accounts & Collections: Accounts unpaid after 90 days are delinquent. Delinquent accounts automatically incur a $300 surcharge PLUS a 1.5% monthly service charge (18% annually). If sent to a collection agency or attorney, you are responsible for the remaining balance plus all collection fees (at least equal to 35% of the outstanding balance), counsel fees, and court costs. Once in collections, we cannot waive fees or contact credit bureaus for lien removals.

Section IV: Legal & Dispute Resolution Agreements

• Agreement to Arbitrate: It is understood that any dispute as to medical/dental malpractice, including whether any services rendered under this contract were unnecessary, unauthorized, improperly, negligently, or incompetently rendered, will be determined by submission to arbitration as provided by New Jersey law, and not by a lawsuit or resort to court process except as state law provides for judicial review. By entering into this contract, both parties are giving up their constitutional right to have any such dispute decided in a court of law before a jury.
• Scope and Procedures: This agreement binds all parties whose claims arise out of treatment, including spouses, heirs, and children. All claims for monetary damages exceeding the small claims court jurisdictional limit against the surgeon, partners, associates, and employees must be arbitrated. A written demand must be communicated to all parties. Each party shall select an arbitrator within 30 days, who will then select a neutral third arbitrator within 30 days. Arbitration shall follow American Arbitration Association rules and New Jersey state law.
• Revocation: This agreement applies to all dental and medical services rendered at any time. It may be revoked by written notice delivered to the practice within 3 days of signature.

• A Note on Public Communication and Defamation: In the State of New Jersey, defamation (including written libel and spoken slander) is defined as the unprivileged publication of a false statement of fact to a third party that causes material injury to the reputation of an individual or business. While subjective opinions and truthful accounts of experiences are legally protected forms of free speech, the publication of fabricated events, demonstrably false statements of clinical fact, or malicious misrepresentations designed to cause reputational or financial harm are not legally protected and constitute actionable civil offenses.