Medicare Contract Information

Dr. Caroline Webber has chosen to opt out of participating with Medicare. Please review the following statements on the private contract you will be asked to sign at your consultation appointment.

  •  I understand that Konikoff Periodontics / Caroline Webber, DDS. has chosen to opt out of Medicare.
  •  I accept full responsibility for the fee due for all services performed by Dr. Caroline Webber.
  •  I understand that I am not allowed to submit a claim myself to Medicare for services rendered or to ask the physician/practitioner to submit a claim to Medicare.
  • I understand that I have the right to obtain Medicare covered services from physicians who have not opted out of Medicare.  I am not compelled to enter into private contracts that apply to other Medicare covered services furnished by other physicians who have not opted out.
  • I understand that Medigap plans do not make payments for services not paid for by Medicare.  
  • I understand that this is a private contract with Konikoff Periodontics/Caroline Webber, DDS. and they have elected to opt out of Medicare.