Patient Forms, Map and Directions to Bartlett Office
Your first visit to Best Dental Group involves a few special steps so that we can get to know you. To understand what to expect, please read through this page. You’ll find all the practical information you need, such as a map and directions to our office, practice hours, payment policies and more. There’s also background information about our committed staff and our first visit procedures. You can also save some time by printing out and completing the patient forms in advance of your appointment.
At Best Dental Group, our highest priority is to provide you with a healthy, beautiful smile while ensuring your comfort and satisfaction. We encourage our patients to take an active role in learning about their dental needs, as well as the procedures that they choose to undergo. Our friendly, informative, and capable staff works hard to create an atmosphere where questions are welcomed and patients are at ease. The Doctors at Best Dental Group have extensive experience in helping to achieve their goals.
Consultation
After the doctor has evaluated your records; we discuss any follow-up
treatment with you in detail, including the cost for your particular case.
Regular Appointments
Regular checkup appointments typically take an hour. Patients are seen by
appointment only. We make every effort to be on time for our patients, and
ask that you extend the same courtesy to us. If you cannot keep an
appointment, please notify us immediately.
Patient Forms
Please fill out these forms online so we can expedite your first visit:
- Financial Policy & Medical History - Online
- COVID-19 Request for Treatment, Representations, and Consent - Online
- Child Health History - Online
Maps and Directions
Our office is a brick building. We are located near TL's Restaurant
and close to the Bartlett Train Station.
Payment & Office Policies
Cost
The cost of treatment depends on the severity of the patient's problem. You
will be able to discuss fees and payment options before treatment begins. We
have payment plans to suit different budgets. We also accept assignment from
most insurance plans, and file the necessary papers to the insurance
company. We work hard to make dental care affordable and to make sure that
you realize your insurance benefits.
Fees
In an effort to keep fees down while maintain the highest level of
professional care; we have established this financial policy:
- If full payment is made at the onset of treatment, we will offer a fee discount since no further book-keeping fee is needed.
- To fit your individual needs for extensive treatments, financial arrangements can be made.
- For your convenience, we accept payment by VISA and MASTERCARD, American Express, Cash, Check.
Insurance
if you have insurance, we will help you to determine the coverage you have
available. Professional care is provided to you, our patient, and not to an
insurance company. Thus, the insurance company is responsible to the patient
and patients are responsible to the doctor. We will help in every way we can
in filing your claim and handling insurance questions from our office on
your behalf.
Privacy Policy/HIPPAA Compliance
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND
DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT
CAREFULLY.
We understand that medical information about you is and your health is
personal "Protected Health Information" (PHI) and we are committed to
protecting your medical information. PHI includes individually identifiable
information about your past, present or future health or condition, the
provision of health care to you, or payment for such health care.
We may disclose PHI about you for treatment, payment, and health care
operations.
Treatment:
We use and disclose PHI to your insurance provider, our dentist(s), and
other dental care providers for treatment purposes. For example, your
dentist may wish to provide a dental service to you but first seeks
information from your insurance provider as to whether the service has been
previously provided.
Payment:
We disclose your PHI in order to fulfill our duty to check your coverage,
determine your benefits, and secure payment for services provided to you.
For example, we use your PHI in order to request process of your claims by
your insurance provider.
Health Care Operations:
We disclose your PHI as a part of certain operations, such as quality
improvement. For example, we may use your PHI to evaluate the quality of
dental services that were performed.
WE may be asked by sponsor of your health plan to provide your PHI to the
sponsor. If we are asked to do so, we intend to honor such requests unless
we are prohibited by law.
We may use or disclose your PHI without your authorization for several other
reasons. Subject to certain requirements, we may give out PHI without your
authorization for public health purposes, auditing purposes, research
studies, and emergencies. We provide PHI when otherwise required by, such as
for law enforcement in specific circumstances, or for judicial or
administrative proceedings. In any other situation, we will ask for
your written authorization before using or disclosing your PHI. If you
choose to sign an authorization to allow disclosure of your PHI, you can
later revoke that authorization to stop any future uses and disclosures
(other than for treatment, payment, and health care operations).
Individual Rights
In most cases, you have the right to view or get a copy of your PHI. You
also have the right to receive a list of instances where we have disclosed
your PHI without your written authorization for reasons other than
treatment, payment, or health care operations. If you believe that
information in your record is incorrect or if important information is
missing, you have ether right to request that we correct the existing
information or add the missing information. You may request in writing that
we not use or disclose your PHI for treatment, payment, and health care
operations except when specifically authorized by you, when required by law,
or in emergency circumstances. We will consider your request but are not
legally required to accept it. You also have the right to receive
confidential communications of PHI by alternative means or at alternative
locations if you clearly state that disclosure of all or part of your PHI
could endanger you.
Complaints
if you are concerned that we have violated your privacy rights, or you
disagree with a decision we have made about access to your records, you may
contact the address listed below. You may also send a written complaint to
the U.S. Department of Health Services. Customer Service can provide you
with the appropriate address upon request.
Our legal Duty
we are required by law to protect the privacy of your information, provide
this notice about our information practices, and follow the information
practices that are described in this notice. If you wish to inspect your
records, receive a listing of disclosures, or correct or add to the
information in you record, or if you have any questions, complaints or
concerns, please contact our office.