Aligners Authorization for Auto-Payments

Overview: Obtain patient consent for monthly auto-debit payments for aligner treatments using the official Authorization for Auto-Payments document.

Prerequisites

  • The patient must have an active Aligner treatment plan.

  • A valid payment method must be identified for the monthly debits.

Obtaining Aligner Auto-Payment Authorization

To ensure compliant recurring billing, follow these steps to secure patient consent for auto-payments:

  1. Access the Document: Locate the official Authorization for Auto-Payments document within the billing resource folder.

  2. Patient Review: Provide the Authorization for Auto-Payments document to the patient for review.

  3. Confirm Payment Date: Inform the patient that by signing the Authorization for Auto-Payments document, they consent to an auto-debit payment on the 15th of each month.

  4. Secure Signature: Obtain the patient's signature on the Authorization for Auto-Payments document.

  5. Record Keeping: Upload the signed Authorization for Auto-Payments document to the patient's record to enable recurring billing.

Auto-Payment Document

Related Information

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