Account Audit/Refund Request

YOUR PREFERRED SAN ANTONIO PEDIATRIC DENTIST

Dear Parent,

In case you have not been contacted by our office, and you believe that there is a refund pending to you and you would like an audit to be made to your account, please complete and submit the form below. A member of our billing department will acknowledge the form and the audit will be processed.

Be advised that the audit and refund will take up to 30 business days from the day it is received. In some instances, our auditor may need to speak with you to gather additional information. Failure to communicate with the auditor or failure to provide the accurate information needed will result in additional delays in the process.

THE BILLING DEPARTMENT WILL NOT BE AVAILABLE TO TAKE ANY INBOUND CALLS REQUESTING UPDATES ON THE PROCESS UNTIL IT IS FINALIZED.

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