New Dental Patients In Beverly Hills

Patient Registration

We want to make your first visit to Beverly Hills Dental Health and Wellness calm and efficient. To save time, you may complete the Patient Registration Form in advance. Simply print this form and complete it at your convenience. Be sure to bring the documentation along to your appointment, as well as a list of medications and supplements you currently take, and any questions you have for the dental team.

Online Registration

Referred by another doctor? Use this form to get set up! If you would like to talk to us prior to the consultation, please indicate that at the bottom of the form with the best number to reach you.

Referral Form

Thank you for choosing our practice as your partner in wellness.

Nutritional Survey

Help us learn more about your nutritional background.

Nutritional Survey

Financing and Insurance

We want to make your dental treatment affordable for you. Please use the links below to be directed to our financial partners who can offer up to one year interest – free payments. Your eligibility will be determined on the spot, right after filling out the 5 minute application.

Notice to all PPO Dental Insurance members

Let me help you get to know your insurance

Dental insurance has been the same coverage since the 60’s. Maximums back then at $1500/2000 was a lot, now not so much. Luckily being a multi speciality office, it’s easy to “max out on your maximum.”

When you are ready to call and obtain your information from the insurance company, locate the number on the back of your card, or if you do not have a card, can contact your HR for this information.

These are the things to ask for and obtain for your records, and for the receptionist that would be billing on your behalf.

  • ID number or subscriber ID # (if you have MetLife they need a social)
  • If the plan is through a spouse, please provide the receptionist with the spouses name and date of birth.
  • Group number
  • Address to mail the claims

Things that you should know for yourself and can easily obtain by calling the insurance are:

  • What is the maximum?
  • What amount do I have remaining?
  • Does this run on a calendar year, or month to what month?
  • Is the deductible waived on preventative?
  • Are major services covered right away, if not how long would you wait to start utilizing the plan to the max?
  • What are my out of network benefits? Are they different from in network coverage?

What is the % of coverage for the procedures listed in bold below:

Diagnostic and preventive procedures, such as cleanings and checkups, are typically covered at the highest percentage (for example, 80% to 100% of the plan’s contract allowance). How often can I be seen? This verbiage is called frequency.

Basic procedures, such as fillings and gum treatment, are usually reimbursed at a slightly lower percentage (for example, 70% to 80%).

Major procedures, such as crowns and root canals, are usually reimbursed at the lowest percentage (for example, 50%).

Procedures can fall under a different category depending on your plan. Please see your plan booklet or Policy for a complete description of benefits, limitations and exclusions.


Similar to car insurance, this is the amount you pay before your benefit plan begins to pay the cost of your dental treatment. A deductible usually doesn’t apply to diagnostic and preventive treatment. But check on this because sometimes preventive isn’t waived.

Being a holistic office be mindful certain procedures we bill for will not be covered, we still try, in hopes that someday they will recognize these procedures should be a covered benefit. ie not covered are ozone, PRF, etc.

What is helpful is when we do a treatment plan, the codes are attached to this plan and you can call the insurance and find out with that specific code, what the coverage would be, ask if there is any restrictions.

The code would start with a letter D*** ie D0120, D4910.

Thank you for taking the time to get know your insurance.

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