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.
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 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.
Please print and fill out these forms so we can expedite your first visit:
- Insurance Information
- Medical History
- Medication Information
- Financial Information
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
Maps and Directions
Our office is the brick building with green awnings. We are located near TL's Restaurant and close to the Bartlett Train Station.
Payment & Office Policies
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.
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 & Care Credit.
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.
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.
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.
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).
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.
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.