Freedom to Choose Providers
It is our belief and philosophy to treat our patients as dental “Guests”. We welcome them into our office with the desire to help meet their dental needs and goals, and for them to become our long-term patients. Finding the right dental provider means finding people you can trust and who care about your health and personal well-being because it involves both a level of professional interaction as well as a personal one. It may mean going to several practices before finding the right practice for your needs, desires, and expectations. There is no one dental office or doctor right for everyone and there is no one patient right for every office. The patient-doctor and patient-staff interaction is a dynamic one that it may take some time to establish a working relationship where expectations of professional services rendered and received are at a comfortable and satisfactory level to both the doctor and patient. Our belief and philosophy is that we value your trust and relationship as we value your business. We do appreciate your business loyalty but we also believe that patient care is more than a financial transaction. In the end, it is a matter of believing and trusting the professionalism, skills, training, and philosophy of your doctor and the doctor’s belief that a patient will be committed, reliable, and compliant in their healthcare that will make a patient-doctor relationship work. Ultimately, we all have the freedom to choose and that includes our healthcare providers. For those who become our long-term patients, it is our mission and goal to provide you with the most comfortable, respectful, professional, and friendly atmosphere while providing you with a high level of service. We want to build relationships and we want you to feel at home!
Full Informed Concent in Our Office
We have general consent forms for most dental work and specific consents for some procedures such as tooth extraction and surgery. If you decline to consent, please notify our staff or doctor so we can address your concerns. We will not proceed with any treatment without your consent, both verbal and written. Please do not hesitate to ask questions regarding your diagnosis or recommended treatment to avoid any misunderstanding during your visit. We believe that our patients should have the full knowledge and consent of their proposed treatment prior to any procedure being done and we do our best to inform and educate our patients to give them the ability to choose and decide their options. Most patients come to the dentist with a non-emergency concern, thereby allowing you the option to accept, decline, or wait for any treatment proposed. However, there are also oral-dental conditions that require urgent attention and care such as obvious disease, infections, abscess, or painful symptoms. The doctor will give you his professional opinion based on his examination and findings. He will then propose a treatment based on his professional judgment as well as patient’s concerns. It is important that patients clearly understand what is being said during the information and presentation process for them to be comfortable with the decisions they make. It is for this reason that we employ the latest in dental education technology and digital imaging coupled with doctor’s detailed treatment plan presentation. We do our best to convey our findings and proposed treatment in the simplest way possible and it is up to the patient to accept, decline, or defer our recommendation. If you do consent to a procedure or treatment plan but you still have lingering questions, the best time to ask is before the procedure.
Treatment Plan Policy
The Treatment Plan is the itemization of proposed procedures and charges after an examination. Doctor will spend considerable amount of time discussing his findings and recommendations with you in order to arrive at a realistic plan that works for you. Your first visit may be a consultation only and involve only treatment planning and no procedures or cleaning. The treatment plan is like a blueprint of your proposed dental treatment and will have a breakdown of the procedures involved, charges, expected insurance payments, and estimated co-pays. It will also include procedures and charges not covered by insurance. The treatment plan presented is for our OFFICE USE ONLY. It is not to be compared with other dentists’ treatment plans because doctors differ in opinions, training, education, skills, philosophies, technology, and equipment available. For example, if you want to replace any missing teeth, one dentist may recommend implants; another dentist may recommend a bridge; then a third dentist may recommend a partial denture. One dentist may retain old, darkened amalgam (silver) fillings or old, worn, stained composites (white fillings) as long as they are functional and another may give you the option of replacing them to improve function, esthetics, bonding strength, repair leaks and wear, or establish ideal occlusion (bite). Each option requires different procedures, scheduling, and costs. Implants are usually the most expensive while dentures are usually the least costly. Some patients don’t want dentures so they will avoid that treatment even if it is the least costly. In some cases, when a patient wants and can afford implants, there may not be enough bone to have them placed or there may be underlying medical problems complicating implant placement. There may be other treatment involved that requires further discussion with your dentist so you can arrive at a realistic treatment plan. Comparing treatment plans of dentists objectively is simply not possible due to differing opinions, technology, and skills of the doctor. We feel that prospective patients should stay with the dentist they trust the most who can meet their priorities, needs, and expectations.
Gingivitis (gum imflammation) and Periodontitis (gum inflammation with areas of bone loss, deep gum pockets, bleeding) are prevalent in a large number of the population. For those who have not seen the dentist in a long time for their regular cleaning, some may require more advanced cleaning if the clinical findings have areas of bone loss, gum inflammation, calculus (hard plaque), and bleeding. These findings indicate the initial stages of periodontal disease which is a detachment of the gums from the tooth and bone due to underlying long-term inflammation caused by bacteria. Periodontal disease may still occur even when a patient has visited their dentist on a regular basis with regular cleanings only but have not been able to maintain their oral health properly at home. This can happen over a very long period of time (years). Proper oral homecare is therefore the essential ingredient in making sure your gums stay healthy and avoid periodontal disease. After all, you only get to see your dentist a few times a year for your cleanings. Doctor will show you his findings by having you hold a hand mirror as well as present a video projection of your x-rays and any oral photos along with an educational video to help explain this disease process and its treatment so you are fully informed about your condition before you proceed with treatment. If you ever have a deep cleaning done (called Scaling and Root Planing), you should only have this procedure done ONCE provided you maintain and follow good oral hygiene habits at home and visit your dentist on a regular basis or as indicated. Deep cleaning should NOT be done as a regular cleaning routine. Doctor will re-examine the health of your gums during your regular check ups so he can know the state of your oral health on a continuing basis. Your insurance dental consultants will also examine the x-rays and clinical measurements submitted along with the clinical findings and make a determination if the deep cleaning was payable in their opinion. In a sense, your insurance acts as a second opinion because they hold and release the funds to pay for your treatment. If the insurance agrees to pay for your treatment, there is usually no further issue because there is agreement in the recommended treatment and its payment. If there is a denial, we can make an appeal as allowed by law. Many conditions in dentistry are non-emergency and not life-threatening, unlike a heart attack or stroke. Therefore, when you ask your dentist if you “need” to have the recommended procedures done, you may get an answer that he or she recommends them based on his/her findings, judgment, and your concerns but it is up to you to weigh your options and make a decision. Note that untreated dental pathology and disease, or defective and non-ideal restorations and oral appliances can lead to more urgent problems in the future.
Our treatment plan for you is specific to your oral condition, your wishes and concerns, and doctor’s judgment. It is always available for you to see and review with us prior to every procedure or making an appointment. The treatment plan is also written in dental jargon and technical terms that a layperson may not fully understand the context of the plan. As the term suggests, it is only a plan that may be modified based on your changing needs, oral status, wants, limitations, and doctor’s judgment. If the treatment plan is complex due to multiple dental work needed, it may be staged in various phases including prioritizing the most urgent and re-evaluating progress before proceeding with the next phase. Your concerns, priorities, and constraints will always be taken into account in the process. The treatment plan is not official or final until the patient signs it and decides to proceed with treatment in our office. If a patient changes his/her mind about a specific treatment or the oral condition changes then the treatment plan changes accordingly. It will be considered as a working plan until a patient finally decides and fully consents to the procedures at his/her time of choice. Depending on the complexity of your case the doctor may recommend alternatives to treatment but it is the patient who finally decides which option to take provided that you understand the risks and benefits of those choices. It is important that you discuss any concerns and questions you have about the treatment plan while you are with the doctor and staff prior to any procedure. We encourage patients to be fully informed of their choices prior to making an appointment with us. You can either accept, decline, or defer our treatment plan. Making or signing the treatment plan does not give you the obligation or the right to have procedures done or become a patient in our office. It is not a contract. It simply means you have seen and reviewed the working treatment plan on that day of your visit. It is not set in stone because your wishes and priorities may change on your next visit. Dentistry is both a science and an art and due to varying opinions and recommendations of different doctors, we encourage patients to stay with the office they are most comfortable with to avoid confusion and conflict. Our doctor and staff are always here to help explain our findings and recommendations in a way that is easy and simple to understand.
The treatment plan remains in our office as a guide to accomplishing your treatment once you decide to proceed with treatment and become a patient with us. Once you seek the services of another dentist our treatment plan is no longer valid in their office because they will make a new treatment plan for you based on their doctor’s opinion and recommendation. In compliance with privacy laws, treatment plan copy and patient records can only be requested by the patient or a qualified legal representative using our release of records form. Time and cost to process copies will be based on existing U.S. and Illinois laws. This request must come directly from the patient or their legal representative to avoid accidental or unauthorized dissemination of medical information. Other providers and doctors’ offices requesting patient records must provide written proof they have legal authority to request records for the patient before there is any release of medical and dental information, verbal or written. Our treatment plan for the patient is not meant to be compared with other dentists’ treatment plans because there are many factors that go into the treatment planning process during the patient-doctor interaction and those factors can change even with each visit including a patient’s financial and time priorities.
One of the alternatives to treatment options is No Treatment. Therefore, if a patient never returns for any treatment after the consultation/exam and did not fully consent to the working treatment plan, we consider this working plan as incomplete, inoperative, and inactive as there is no further input from the patient and doctor cannot know the current oral condition of the patient. We would then consider the patient to have elected the No Treatment option if he/she does not return, consent, or respond to our inquiry. He will also be inactivated or become non-patient in our office. Completing and finalizing the treatment plan is a bilateral decision between the patient and doctor. The patient must fully understand, gives input, decides, consents, and signs to the working plan before it is considered official and final. This gives the patient both a share of control and responsibility for their healthcare. The doctor can only guide and make recommendations to the patient but he cannot make the decision for him/her. If a patient conveys to us that they are seeking the services of another dentist or under his care, he/she becomes inactivated as a patient in our office until he/she decides to return for treatment. This intention by the patient would make the working treatment plan null and void as it cannot be completed and finalized without patient’s consent. It is not advisable to have two independent general dentists treating the same patient for the same things or it may create confusion and conflicts among dentists and the patient. We advise patients to stick with one dentist at a time for better continuing care.
Scheduling the Appointments
We consider your oral care and your time to be important. When we set up an appointment for you, we dedicate considerable amount of time and effort doing administrative work and clinical preparation. We verify your insurance, coordinate your treatment with other doctors’ offices, we modify our overall schedule to accommodate you, we prepare clinical instruments and materials, and we employ a certain number of staff to meet your dental needs. When you book an appointment, we have several staff members waiting for you, including the doctor. There are significant costs associated with booking your appointment and other patients are denied that time we have allocated for you. Please consider every appointment very important! Because there is a limited time for your appointment, please come on time or 15 minutes early for some paperwork and be prepared for your visit as instructed by the person with whom you made the appointment, especially for surgical procedures. Please get plenty of rest, an adequate and healthy meal, and plenty of fluids prior to your surgical visit, such as extractions (removal of teeth). We also suggest this for long procedures (more than 1.5 hours).
We will schedule a maximum of 2 patients per family per day unless otherwise approved by the doctor. This helps give other patients the chance to have more available time to schedule. We encourage patients to have escort or guest during their procedures, especially surgery. An escort who can drive you is preferable. However, please limit your guests to 2 people due to limited seating in the lobby for other patients. If you cancel within 48 hours, you may become a walk-in to avoid a similar cancellation in the future or we may assess a fee to reschedule. If you feel that you are not comfortable with the cost of your proposed treatment or the treatment plan itself, please do not hesitate to notify the doctor to see if he can modify the phase of your treatment. If you know you will cancel an appointment for whatever reason, please do not make the appointment. We would rather have you be more sure of your appointment than for us to deny other patients the available time on the schedule. We will confirm all appointments at least 1-2 days prior to your visit. Please note that cancellation history is noted on your account. Repeated cancellations will inactivate your account with us and we’ll send you a letter advising you to seek the care of another dentist. If you are running late or need to reschedule or cancel, please call our office as soon as possible. Patients who do not give us the courtesy of calling if they cannot make their appointment may be considered as walk-in for future visits. We value and respect your time and visit with us; we only ask that you do the same. If you have any questions prior to your appointment, please call our office.
Financial Policy
The estimated cost given with the treatment plan is only an ESTIMATE if you have insurance. This is because the estimated cost is based on expected insurance payments. Your insurance may change their fees, coverage, and payments of charges. Your insurance usually sends you a copy of your Explanation of Benefits (EOB) and will itemize what they cover and paid and also what they denied. The patient is ultimately responsible for unpaid balances regardless of insurance payments because the charges reflect the services we have already provided to you. We verify eligibility with your insurance; we do not control what and when your insurance pays. Only your insurance company can make that decision even when procedures have been pre-approved because claims for services rendered are reviewed by the insurance only after procedures are done. However, most pre-approved procedures are more likely to be paid. We cannot possibly know every detail of every insurance policy of every patient. Many insurance policies will mention that it is the policyholder who should be familiar with their own policy. Read your policy and notices from your insurance regarding pre-approvals, benefits, and claims to be informed. Our office can answer some of your insurance questions but it is your insurance that can best answer your most detailed ones. Your insurance policy is your agreement with your insurance and they can best explain the reasons for denials and payments if we cannot answer them. Your agreement with us is to provide you dental services with expected payments from your insurance. Because your insurance cannot assure or guarantee us payment, we also cannot assure you of their payment even if they verified your eligibility. We submit insurance claims for you and will bill you for any remaining balance after we receive any payments from them. All deductibles and expected copays are due once procedures are done. We will follow the EOB of your insurance, therefore, if there is a credit it will be credited to your account or refunded OR if there is a balance you will be billed accordingly. Please address unpaid charges with your insurance if claim for services provided to you are denied. We may resubmit claims if possible and only at our sole discretion but we cannot guarantee your insurance will pay. Your insurance policy is solely your agreement with your insurance.
PPO vs. HMO
There is a big difference between PPO and HMO insurances. For patients with PPO insurance, there is a significant number of providers you can elect to choose from within your network. You do not have to be assigned to any office to be accepted as a new patient in the office of your choice. If the office you choose participates within your PPO plan network, you will be charged discounted PPO fees. If your plan does not include our office within your PPO network, you will be charged our regular office fees and your PPO plan will determine the amount they will pay. Check with your insurance for details. We do take many PPO plans. Call our office to inquire.
Unlike PPO, if you have HMO insurance you have to be assigned to a specific office to be considered a patient if that particualr office is in your network. Our office only participates in a few HMO plans and we are limited in the number of new patients we accept. Please check with us if we accept your HMO plan and if you can be assigned to our office. In terms of what you pay for procedures, there is also a significant difference between the two. For HMOs, many diagnostic and preventive things such as exam, x-rays, and regular cleaning have no patient fee. If a deeper cleaning is indicated, you willhave a fee including any fees for supplemental procedures. Most HMOs will specify the fees patients need to pay once procedures are done. We normally do not get additional payments from HMOs for procedures. We offer our HMO patients deeply discounted fees and they pay their insurance-stated fees at the time of their visit. Your HMO will not “cover” or pay anything additional except what we collect from your stated fees. There may be a nominal HMO office visit fee stated by your insurance. Unlike HMOs, PPOs have a shared percentage coverage for procedures that are covered within your plan. We will verify your eligibility prior to treatment and will show you a breakdown of proposed treatment plan. It will show what is the expected payment from your PPO plan as well as your copay. Note that all proposed treatment are only shown as an estimate because we do not know what and when your insurance will pay (see Treatment Plan Policy).
If you have HMO insurance, you are responsible for the entire amount on the treatment plan should you wish to proceed with treatment. We do not submit claims to your HMO insurance unless your plan has special provisions.
For major dental work, such as crowns, dentures, bridges, there may be associated lab fees, shipping and handling fees, or upgrade fees. We will show you estimated charges prior to any work being done. You are ultimately responsible for knowing your specific insurance plan policy and make your decisions accordingly. Though we can help you with some basic questions about your plan, we encourage you to call your insurance if you have any questions prior to making appointment with our office. It is not possible or practical for us to know every detail of your plan; we are largely responsible for your oral care and maintenance of your oral health.
If doctor believes you are asking for less than the standard of care for your cleaning or oral care, because you choose to settle for less than what is clinically indicated, or do not agree with the diagnosis or recommendation, he may advise you to seek the care of another dentist. Doctor will not compromise your oral-dental care because it is the cheaper thing to do as he has the duty to inform you of his findings and his professional recommendations (see Freedom to Choose Providers).
Silver Fillings (Amalgam) and White Fillings (Composites)
Composites (white fillings) are the more common fillings today because it appears that the public demand more of this type of restoration and their durability has markedly improved. Amalgams (silver metal fillings) are being done less often but many insurances either do not cover composite fillings on back teeth or will downgrade coverage and payments on composite fillings to amalgams. They call it Alternate Benefit. Similarly, if a crown with a higher gold content or porcelain/zirconia crown is placed on a back tooth, your insurance may downgrade payment to a crown with a base metal (without gold) or a full metal crown. We can only verify eligibility and coverage on these restorations but we cannot guarantee what they will pay. Accordingly, any unpaid claims for these restorations shall be reflected in your insurance Explanation of Benefits (EOB) as well as your account with us. Please note that we are not adding additional charges for these restorations. Additional balances are due to downgraded underpayment by your insurance.
OSHA and HIPAA
Composites (white fillings) are the more common fillings today because it appears that the public demand more of this type of restoration and their durability has markedly improved. Amalgams (silver metal fillings) are being done less often but many insurances either do not cover composite fillings on back teeth or will downgrade coverage and payments on composite fillings to amalgams. They call it Alternate Benefit. Similarly, if a crown with a higher gold content or porcelain/zirconia crown is placed on a back tooth, your insurance may downgrade payment to a crown with a base metal (without gold) or a full metal crown. We can only verify eligibility and coverage on these restorations but we cannot guarantee what they will pay. Accordingly, any unpaid claims for these restorations shall be reflected in your insurance Explanation of Benefits (EOB) as well as your account with us. Please note that we are not adding additional charges for these restorations. Additional balances are due to downgraded underpayment by your insurance.
Feedback and Disputes
We have an open door policy on feedback, suggestions, and complaints. Please look for our suggestion box for your written input. You can also email us regarding your concerns. Every issue has a story and we strive to learn the truth of every story so we can arrive at a meaningful resolution. Though it is our aim and goal to provide the best care and service possible for all patients, some may not be satisfied with their visit or they have a complaint they want addressed, including areas of misunderstanding. Many disputes arise from lack of communication and it is our never-ending goal to improve communication with our patients at every opportunity. A vast majority of our patients are very respectful and civil in how they address their concerns and they are largely resolved without any further issues. We also recognize that we cannot keep or please every patient who comes to visit us despite our best efforts, but we also know that not everyone belongs to our office. We have internal feedback and suggestion mechanisms in place to listen to your concerns:
A. Address the issue with the staff member helping you at the time of your visit. We can then refer you to a Dispute Resolutions Coordinator (DRC) if your issue deserves more attention.
B. If you are unable to resolve the matter with the DRC, you can address your issue with the Director/Office Manager by phone or in person. She is not always in the office and you may need to set up a time to discuss the issue with her.
C. If you are unable to resolve your issue with the Director/Office Manager, you can talk directly to the doctor about your concerns, by phone or in person. Note that doctor may be busy with patient care and will delegate routine questions to staff members. He may also ask that you make an appointment to discuss the issue with him.
D. If you are unable to resolve your issue by verbal communication, you can also write a letter to the Director or doctor about your concerns. This method may avoid instance of heated argument and may present your concerns more clearly.
E. If you have insurance issue and are unable to resolve the matter with our office, you can call your insurance to discuss your issue and our office would be glad to coordinate a conference call with them, if possible.
Because we believe in personalized service, courteous interaction, and client satisfaction, we will do our best to address your concerns provided they are within reason and they are legitimate. Where there are areas we can improve we will make the change as soon as we can.
The best way to address your concerns and arrive at a meaningful resolution is through our office resolution process. We believe in honest, straightforward discussion of your concerns taking into account your circumstances as well as our limitations. We only ask that during your inquiry or complaint that you maintain a civil, calm, and respectful conversation with the staff members, director, and the doctor. We can only come to an amicable resolution if you clearly state your issue and make a legitimate case. As we seek to understand your situation and concerns, we also ask that you listen to our explanation. We are accommodating and responsive to courteous and rational pleas.
For the very rare and minor few: For the respect of our patrons, staff, and business premises, we will not see or tolerate any patient who is yelling, screaming, using expletives or derogatory language, exhibits or commits hostility, harassment, cyberstalking, cyberharassment, unwanted phone calls, defamation, bigotry, racism, physical threats, violence, office disturbance, legal threats, and any other inappropriate behavior. We take any of these unacceptable behavior very seriously and will refer the matter accordingly to proper authorities and/or our legal counsels. We will also immediately terminate you from our office. We are a private professional entity with individuals working in this office; and we also have rights as you have rights. If you respect us, we will also afford you the same respect and there will be a better chance that any dispute will be resolved more satisfactorily and amicably. We would greatly appreciate your cooperation.
**The policies in this website reflect the general protocol of the office. These are not our complete policies. Our policies may change without notice.**