Paperwork and Other Official Stuff

The information we request is always kept confidential. Medical information is imperative so we know how best to work with you and your other medical teams if needed. Things like medications, chronic illness, pregnancy and past dental experiences are necessary details so we provide exceptional precision dental care. We ask you fill out the new patient forms prior to arrival.



Do you take my insurance?

We work with 100% of PPO providers. Our team will jump through all the hoops and red tape for you so you can focus on your health. We are in network with Cigna, Assurant and Aetna. For patients without dental insurance, we have an in-house membership plan that many find easier and better than traditional insurance options.


Miami Sedation & Cosmetic Dentistry Prestige Membership Plan

If you’d like more control over your dental experience or if you’d like all the benefits of dental insurance without the red tape a Prestige Membership is right for you. When you join our Prestige Membership Plan you receive all your basic preventive care as well as discounts and bonuses for one low monthly payment.


  • No deductibles
  • No pre-existing condition limitations
  • No yearly maximums
  • No frequency limitations
  • No services ‘denied’
  • No third-party decision making
  • No claim forms
  • No pre-authorizations
  • No waiting periods
  • Discounts on other services

Membership Rates (ANNUAL FEE)

Adults $394.00 (1st year)
Renewal (Adult) $394.00
Children Under 13 $225.00 per year

Membership Program Includes:

  • 2 Dental Cleanings – Prophylaxis D1110 or D1120 (in the absence of periodontal disease) OR
  • 2 Periodontal Cleanings- Periodontal maintenance D4910 (following active gum treatments)
  • Unlimited Oral Exams- D0150,0120,0140
  • Annual Periodontal Evaluations – D0180
  • Annual oral cancer screening – D0431
  • Unlimited digital x-rays and intra-oral images – D0210,0220,0230,0272,0274,0330
  • Fluoride treatment as necessary for children under 13 – D1206

Additional Benefits:

  • Additional dental cleaning – Fee reduced 15%
  • Emergency Services – Fee reduced 15%
  • Periodontal Procedures – Fee reduced 15%
  • All general dentistry (except fillings) – Fee reduced 15%
  • Fillings – Fee reduced by 20%

Terms of Membership

The 12-month membership fee is due upon joining. Membership will become effective upon receipt of dues, with no waiting period. It is the sole responsibility of the member to maximize their benefits by arranging all appointments within the 12-month membership period. If the appointments are not used, the member will not be entitled to a refund. Appointments included with your membership are not transferable to another patient or extended beyond your membership expiration date. Renewal payment is due the beginning of the same month each year. The anniversary month of your membership is the month you originally joined, regardless of when payment is received. All membership plans are non-refundable and non-transferable.

Discounts under your membership do not apply to any treatment that was done prior to joining.

Program Exclusions and Limitations

Our membership is not a dental insurance plan and can only be used at Miami Sedation & Cosmetic Dentistry. This plan cannot be combined with any other discount offer, coupon or insurance carriers. The membership cannot be used for hospitalization or hospital charges of any kind. The membership cannot be used in combination with workman’s compensation. The plan cannot be used for treatment, which sole opinion of Dr. Bana, lies outside the realm of his expertise. The plan cannot be used for costs of dental care which is covered under automobile or medical insurance. Payment for service is due when service is rendered, unless prior arrangements are made and approved. Discounts under your membership do not apply to any treatment prior to joining. Discounts under your membership cannot be used for any family member on your account unless they have also paid a membership fee.

Other Financing Options

We also work with three trusted flexible financing companies. If you have questions, don’t hesitate to ask our knowledgeable team, we’re always happy to help!


CareCredit® is one of the leading healthcare credit cards accepted at over 175,000 providers nationwide. Pay upfront for necessary procedures, and make affordable monthly payments that work with your budget. CareCredit financing is flexible, convenient, and the application process is simple.

Apply with Care Credit®


Lending Club is the world’s largest online marketplace. Lending Club partners with doctors and practices like ours to help make patient financing easy and affordable. Lending Club offers quality plans, low fees, and high approval rates.

Apply with Care LendingClub


GreenSky works differently than most other healthcare financing options available today by approving patients for a loan rather than a credit card. GreenSky does not charge loan origination fees or penalize patients for early prepayment. They also offer a wide range of payment plans to choose from. The application process is simple and loan approval decisions are made (on average) in under a minute.

Apply with Care GreenSky™ – English

Apply with Care GreenSky™ – Spanish