Dental Specialist dedicated to infants, children, adolescents & children with special healthcare needs.


7655 Five Mile Road, Suite 214

Cincinnati, Ohio 45230


Pediatric Dentistry

of Anderson

Ronald L. Poulos, DDS, LLC


American Academy

of Pediatric Dentistry

Board Certified:

American Board

of Pediatric Dentistry




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Financial Information

Patient Forms

We appreciate you permitting us to provide dental care for your child. We value your trust and believe that the best relationships depend on open and honest communication.


As part of this communication, we offer clear and complete information regarding methods of payment and insurance reimbursement.


At the time of your first visit, we will request a copy of your dental insurance. Please remember to bring this information with you, so that we may have it in your child’s record. It is important that you notify us of any changes in your dental insurance, since this will expedite reimbursement for covered charges.


As a courtesy to our patients, we will be happy to apply your insurance benefits. Because your dental insurance is a contract between you, your employer, and the insurance provider, deductibles and co-payments may vary depending on the employer’s contract choice.


Any amount not covered by your insurance is payable at the time services are rendered. These fees include deductibles, estimated

co-payments or procedures not covered by your policy. We allow

a maximum of 60 days for your insurance company to resolve any claim. Any unpaid portions will be your responsibility after this period.


For your convenience, we accept cash, checks, and the following major credit cards: Visa, MasterCard, and Discover. We also offer Care Credit financing. All returned personal checks will be assessed a $25 management fee.


To help provide cost-effective care for our patients, we offer long and short-term financing programs for both dental and orthodontic treatment. Please feel free to inquire about these various payment programs.


Please remember, our office is always here to assist you, so feel free to contact us with any insurance or payment questions.