(805) 492-3553

430 E Avenida De Los Arboles #102, Thousand Oaks, CA 91360

 


Welcome to TOSD Patient Center 


PatientConnect gives you secure 24x7 web access to your account with Thousand Oaks Smile Design.

Your Appointment and Treatment History

Ability to Request Appointments Online

Your Account and Insurance Balance

Convenient Online Payment Options

If you have your email on file with Thousand Oaks Smile Design, please click the Register Here button below.

If you do not have an email on file, please call the office at 805-492-3553 and ask them to add your email address to your patient file, so you can access your PatientConnect account.


New Patient Form

We are delighted to welcome you to our practice and are pleased that you have chosen us to serve your dental needs. We are serious about providing superior dental care and proud of our dedication to our patients. Our goal is to help you feel and look your very best through excellent dental care. 

To facilitate being seen just as soon as possible at the time of your appointment, we would appreciate it if you would complete your registration prior your appointment. Please arrive 10 minutes early to your 1st appointment, allowing time for our staff to review your information. If you wish to complete these at our office, please arrive at least 20 minutes early. Of course, if you have any questions just give us a call or ask us upon arriving at our office.

Once completed, you will not have to fill out any more forms at subsequent visits to us. Our modern facility is fully equipped and computerized, allowing us to better serve your dental treatment needs and to aid in financial matters, to promptly process insurance claims and to have reliable and innovative ways for you and our office to communicate.

Please click the “New Patient Form Button” to complete your patient forms on-line.

 

 


 

New Patient Welcome Package

The "New Patient Welcome Package Button" below will allow you to view/ print a copy of our "New Patient Packet", which includes our Welcome Letter, Payment Policy, Appointment Cancellation Policy and a HIPPA privacy act. 

 


 

Privacy Statement

 Our Commitment to you:

• We will safeguard with strict confidentiality any personal health information that you share with us

• Our employees are trained in privacy practices

• We do not provide patient list for any vendors or unaffiliated third parties

We Do:

• Send information and x-rays of your condition to your dental insurance
(i.e. for a fixed bridge prosthesis, fillings, crown) including your name and address

• Review your pertinent health information with another physician, dentist or specialist that could be involved with your treatment either written or orally

• Intra-office review of information between our staff members

HIPAA Regulations

These are new federal regulations that require us to notify you that your health, dental and other information may be used for treatment, payment and general operations.

We must make the effort to secure your acknowledgement of receipt of this notice.

As usual, you always have access to this information with a few exceptions.


 

Payment Policy

It is the goal of all of us here at Thousand Oaks Smile Design to provide you optimal dental health by offering quality dental care through treatment options and financial arrangements that meet your individual needs. Payment is due at the time of service, except for that portion of fees in which payments from an insurance plan can be sent directly to us. Our staff will help you choose one or more of the options below to finance your dental treatment.

  •      • Cash
         • Check
         • Visa, MasterCard, AMEX & Discover
         • Care Credit Payment Plan
  •        If you desire a payment plan after discussing treatment options with your Doctor and do not wish to use a credit card, our staff will be happy to explain how          this special line of credit for dental treatment works and will help you with the simple application process.
    •      • TOSD Membership Program 
    •        Because we value your loyalty we've created our own loyalty program to simplify payments for preventative care. Our membership members also save                  money on treatment.
  •      • Flexible Spending Accounts or Cafeteria Plans
           Many companies have implemented benefit options that make elective treatments an affordable alternative. These insurance programs are referred to as              Flex Spending Plans, Cafeteria Plans or Alternative Health Plans.

     • Insurance Payments: Our staff will help you to understand your insurance policy and to maximize your plan’s benefits to achieve your treatment goals.

If you have an insurance plan that will pay us directly, you will pay only that portion of fees your insurance plan does not cover (our staff will discuss this with you). We expect primary insurance benefits to be paid within 30 days. After 30 days you will become responsible for the entire treatment fee.

For those that have dual insurance (2 plans) the Secondary insurance claim cannot be sent until the Primary insurance claim is paid. In the event of late Primary insurance claim payments, after you have already paid your balance in full, we will deposit it toward any current balance on your account or sign the check back over to you. We would then be able to send out the Secondary insurance claim.

At any rate, even if you have ongoing insurance claims for your account, you need to pay that portion of your balance that is 60 days old to avoid being charged a $50.00 late payment fee.

Our staff is always available to answer any questions you may have about your account, your insurance coverage, the use of credit cards, our Care Credit payment plan and any billing issues.

The Staff at Thousand Oaks Smile Design


 

Appointment Cancellation Policy

Thousand Oaks Smile Design is committed to providing all of our patients with exceptional care. When a patient cancels without giving enough notice, they prevent another patient from being seen.

 

Please call us at (805) 492-3553 48 hours prior to your scheduled appointment (no text please) to notify us of any changes or cancellations. To cancel a Monday appointment, please call (no text please) our office by 10:00 a.m. on Friday. If prior notification is not given, you will be charged $75 per hour fee for the missed appointment.

 

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