This agreement is entered into between; the individual enrolling in the plan (“you” or “your”), Dental Health Advantage Plan, LLC (“DenVantage”), and the dental practice service provider (“Dentist”) through whom you enrolled in the DenVantage plan (the “Plan”).
The Plan is a membership arrangement designed to keep dental care affordable by reducing your Dentist’s overhead costs and passing those savings on to you in exchange for your payment of a low monthly membership fee as outlined in the enrollment form provided by your Dentist and signed by you. The benefits of the Plan are outlined in the schedule of benefits provided by your Dentist (“Benefits”). YOU UNDERSTAND THAT THE PLAN IS NOT INSURANCE. IT IS A MEMBERSHIP PLAN THAT OFFERS REDUCED FEES, ALLOWING YOU TO SAVE MONEY. By clicking “I agree” below and paying the fee, in addition to the terms outlined in the enrollment form and schedule of benefits, you agree to the following:
- Your enrollment in the Plan is effective on the date of your Dentist’s receipt of your first payment (“enrollment”) and will renew automatically on an annual basis without action by you, unless and until terminated by you, your Dentist, or DenVantage. Your enrollment will automatically terminate in the event of nonpayment.
- Plan Benefits for each 12 month enrollment period do not roll over. It is your responsibility to take advantage of Plan Benefits within each applicable 12 month enrollment period, or lose them.
- The Plan cannot be transferred to another dental practice. To change to another dental practice offering the Plan, you must submit a new enrollment form and such a change will be deemed a cancellation of the prior Dentist subject to Paragraph 7 below.
- In exchange for your payment of the membership fee specified in the enrollment form, your Dentist will provide the Benefits as written in the schedule of benefits.
- Membership fee payments will be processed automatically on the same day each month based on the initial start date of the Plan, from your debit/credit card, or a savings/checking account as specified at initial enrollment, unless you choose to pay in full up front, and will continue until you cancel the Plan in writing. You may be charged a service fee in the event of a payment denied for insufficient funds or for a credit/debit card that is denied repeatedly by the processor.
- You agree to also pay a one-time processing fee per enrollment. Currently the fee is $55 for individuals and $95 for families.
- You may cancel the Plan at any time; however, if you cancel prior to the end of a 12 month enrollment period, you will be responsible for the usual and customary fees for all dental services rendered during that time, less any payments made to the Plan.
- Written notice at least 30 days’ prior to renewal will be given if the processing fee or membership fee changes. The Plan will continue past the renewal date at the new fee, unless cancelled.
- You acknowledge that DenVantage is not a dental provider and you agree to release and discharge DenVantage from any and all claims and liabilities arising from or connected with your, or your child’s, participation in the Plan, or arising from or connected with the dental services received by you or your child(ren).
To keep overhead costs low, you agree to comply with the following Dentist policies:
- All payments to the Dentist must be made in full by the time of treatment. (Note: services covered by the Plan at 100% do not require any additional payments.)
- Failure to pay for services by time of service will result in the loss of the benefits for that service.
- As a courtesy to the dental team and other patients, a full week’s notice is requested for any appointment changes whenever possible.
- Your Plan payment signifies that you agree to a minimum $40 rescheduling fee for missed appointments, or appointments that are cancelled with fewer than two business days’ notice. For appointments scheduled for more than an hour in length, $40 per scheduled hour will be charged for the missed appointment. (Missed appointments are one of the highest overhead costs, of which the $40 rescheduling fee covers only a small portion.)
- The Plan may be discontinued at any time at the sole discretion of Dentist and/or DenVantage.
This agreement, and the documents referenced in this agreement, contains the entire agreement of the parties. No terms, conditions, understanding, or agreements purporting to modify or vary the terms of this agreement shall be binding unless made in writing by DenVantage.