Patient Information and Bill of Rights

Please read this very important information about your visit to the LECOM Dental Offices

Welcome

We thank you for choosing the LECOM Dental Offices, a community outreach service of the LECOM School of Dental Medicine*, as your dental care provider. The faculty, staff and students are committed to providing you with the highest quality and most comprehensive dental care available. This pamphlet contains important treatment and payment policy information for patients of the LECOM Dental Offices. We urge you to take time to read through it carefully. Direct any questions you may have to your student dentist, faculty member or the Patient Care Coordinator.

About the LECOM Dental Offices

The primary role of the LECOM Dental Offices is the training of dentists. This is a teaching institution and not a private dental office. The care performed by our student dentists and overseen by our faculty is done in a manner that gives priority to education and quality care. This may result in longer appointments for most of our treatments than would occur in a private dental office. Treatment will include all general dentistry care that the student dentists are qualified to perform.

It is necessary to apply to receive care and not all patients who apply to the LECOM Dental Offices will become active patients to be treated by our student dentists. The LECOM Dental Offices offers preventive and primary care restorative dentistry, which includes cleanings, periodontal (gum) treatments, single crowns, simple root canal therapy, simple extractions, and denture treatments. Patients who receive treatment will be charged a fee to cover the operating costs and services of the clinic.

How to Become a Patient

The first step in making an application to participate in our program is to arrange for an initial examination to determine if your treatment needs would qualify you as a potential teaching case. Appointments may be made by phone or in person at the LECOM Dental Offices (please see listings at the end this document). Appointment hours are available Monday through Friday 7:00 am to 7:00 pm in DeFuniak Springs and Erie and 9:00 am to 5:00 pm in Bradenton excluding holidays and LECOM school breaks.

Teaching cases are selected based on the scope of the clinical education programs. Therefore, not all people can be accepted since there is a limited capacity in some treatment clinics. Some patients will not qualify for treatment in our predoctoral student clinic at the LECOM Dental Offices because their treatment needs are not within the parameters of the educational program.

At your initial appointment, a limited exam and other diagnostic aids such as X-rays may be ordered. If X-rays have been taken within one year, you may bring them from another provider; however, in most cases, we need to take additional X-rays in order to provide a proper diagnosis and to develop an appropriate treatment plan. If selected, our Patient Care Coordinator will match your treatment needs with a student dentist. Patients should consider the amount of time necessary to complete their care at the LECOM Dental Offices to make sure this will not impose any undue hardship. Your student dentist will also have periodic educational breaks similar to other teaching institutions and during these times the patient clinics are not open.

A dentist-patient relationship is not established until the comprehensive exam is completed by the student dentist and the patient is determined to be teachable within the scope of practice of the dental student.

Once the dentist-patient relationship is established you have rights as our patient and you are encouraged to let us know if you feel we have not lived up to our pledge, or if you feel that your rights were not honored.

New Patients

Please bring the following items to your first appointment:

Photo ID
List of prescription medications

If the above information is not provided, your appointment may need to be rescheduled.

Appointments

All treatment in the LECOM Dental Offices predoctoral clinical program is provided by students. Your assigned Patient Care Coordinator or student dentist will schedule your appointment. Service starts promptly at your appointed time, Monday through Friday.

You should plan to be available at least four hours during the week for your dental treatment. This may be two (2) two-hour appointments, or one (1) three-hour appointment, depending on the nature of the procedure. Since you are being treated by student dentists who will be overseen by faculty members, your appointments may be longer and possibly less treatment will be rendered than if you were treated by a private dentist.

If you have children, we request that you make arrangements for their care since we will be unable to have them present in our teaching operatories. Patients with the most flexible availability will be the easiest to assign to our student dentists.

Appointment Cancellation

Appointments should be canceled only if it is absolutely necessary and at least 24 hours in advance of the scheduled appointment time. If you are calling to cancel an appointment during hours when we are not open, you may leave a phone message with your assigned Patient Care Coordinator. An appointment “failure” is a canceled appointment within 24 hours of the appointment time, not showing up for a scheduled appointment, or arriving more than 30 minutes late for a scheduled appointment. Three “failures” in one year may result in your treatment being terminated. Please remember, your student dentist depends on you to come to your appointments as there is a limited amount of time for them to achieve the necessary clinical experiences for graduation.

Clinic Calendar

The LECOM Dental Offices are closed on the following holidays: Labor Day, Thanksgiving, the day after Thanksgiving, Christmas, New Years Day, Martin Luther King Day, Memorial Day, and Independence Day.

Dental Emergencies

Our DeFuniak Springs and Erie clinics are open from 7:00 am to 7:00 pm Monday through Friday and our Bradenton clinic is open from 9:00 am-5:00 pm Monday through Friday throughout the school year, excluding holidays and breaks. If you have an emergency on a weekday, please call your assigned clinic for an appointment. For severe dental emergencies occurring after hours, on weekends, or on holidays-such as intense pain or swelling-please call your assigned clinic or go to the nearest emergency room.

Payments for Services

Payment for dental treatment is expected at each visit. We accept cash, check, and credit cards (VISA, MasterCard) for payment of services. Please note that we do not have a sliding fee scale or provide free care. Payment is expected in full when the service is rendered.

Notice of Non-Refundable Treatment Suspension Fees

In the event treatment suspension is requested by the patient, with or without notification, 50% of the treatment fee will be retained for internal or external dental laboratory fees and or to allocate for treatment costs up to the time of suspension. 50% of the total treatment fee is non-refundable for treatment involving dental bridges, dental crowns, dental implants, dentures, partial dentures, and endodontics.

Refunds of remaining funds will be allocated to the original payment method. If payment was made by check/cash, a check will be issued.

Dental Insurance

LECOM Dental Office participates with a select number of Medicaid insurance plans. It is the patient’s responsibility to provide the Patient Care Coordinator with their insurance card at time of check-in for dental appointments. If a patient has a private insurance or one that the LECOM Dental Office does not participate with the LECOM Dental Office will provide the necessary information for you to submit to your insurance carrier, but it is not the responsibility of the School to complete this.

Fee Estimates

Patients will be advised of their ideal treatment plan and its estimated costs, as well as any alternative treatment plans. You and the attending faculty member must sign-off on the treatment plan once the plan is understood and accepted. The accepted treatment plan will be entered into your dental patient chart. At each visit, patients should be advised of the costs of each succeeding procedure so that they are prepared for the subsequent charges. Please ask your student dentist if this is not clear. These estimates are based upon current fees and may vary from the actual cost if the services or procedures are performed after an extended period of time.

Fee Schedule

All student dentists, faculty, and appropriate clinical staff members have copies of this schedule and should be able to discuss fees with you prior to beginning any treatment or care. The LECOM Dental Offices administration reviews the fee schedule annually with the Assistant Dean of Clinical Education.

Patient Inquiry

If you have any questions about your treatment or your bill, you should first contact your student dentist or Patient Care Coordinator. Resolution of non-financial problems and/or complaints should be addressed while you are in the clinic. In the event that this effort is unsuccessful, you and your student dentist should consult the faculty member in charge of your practice group. Should the nature of the complaint or problem go beyond this level, the student should contact the Patient Care Advocate.

Treatment Policies – Comprehensive Care

Patient selection is based upon the educational needs and resources of the LECOM School of Dental Medicine. Generally, comprehensive care will be recommended while advising the patient of the benefits and risks of this course of treatment, as well as the prognosis or outcome. At least one alternative treatment plan may be advised with its attendant benefits, risks, and prognosis. Patients will not have the option to select only limited portions of the recommended treatment plan for dental care except for dental emergencies in which care would be limited to the relief of pain and swelling and necessary steps to assure that the situation does not recur.

After your initial appointment, you will have one or more additional appointments to determine your personal treatment plan depending on the complexity of your case. Please bear in mind that less expensive treatment plan alternatives also represent less permanent solutions to your dental health problems.

Each treatment plan will be thoroughly explained to you so that you understand what you can expect, how much the treatment will cost, and the risks both physically and financially. If at any time, you feel that your rights and requests are not being honored and you cannot resolve the situation with your student dentist or staff person, you shall have access to a Patient Care Advocate to assist you.

Patient Records

The LECOM Dental Offices has the primary custodial rights over patient records. You, as the patient, have a right to review or obtain a copy of your records. Copies of your records and radiographs (X-rays) will be provided to you or forwarded to another practitioner upon your signed, written request. There is a nominal fee charged for the duplication of radiographs which must be paid prior to the copies being released. The original records will remain with the LECOM Dental Offices.

Policy of Non-Discrimination

The LECOM Dental Offices accepts all patients with dental needs that are considered appropriate for teaching students contemporary techniques of dentistry regardless of race, ethnicity, color, religion, creed, national origin, gender/sex, marital status, sexual orientation, gender identity/expression, age, disability, status as a veteran or disabled veteran, or any other legally protected characteristic.

However, the LECOM Dental Offices reserves the right to refuse treatment, except to relieve pain or protect life, to any person for the following reasons:

The patient (or his/her immediate family) has a history of not fulfilling their financial obligations to the LECOM Dental Offices.
The patient (or his/her immediate family) has a history of not abiding by the patient responsibilities listed below.
The patient’s conduct is disruptive or compromises the rights of others.

Your Rights as a Patient

We want you to know that you have rights as our patient and encourage you to let us know if you feel we have not lived up to our pledge, or if you feel that your rights were not honored.

Patient Rights

You have the right to considerate and respectful care.
You have the right to complete and current information concerning the diagnosis and treatment of your dental condition, including its prognosis, in terms that you can understand.
You have the right to request a transfer to another student if you are dissatisfied with your student dentist. However, requests to be transferred to another student on the basis of race, ethnicity, color, religion, creed, national origin, gender/sex, marital status, sexual orientation, gender identity/expression, age, disability, status as a veteran or disabled veteran, or any other legally protected characteristic will not be honored. Requests for transfer to another student are to be made with the Patient Care Coordinator in conjunction with the supervising faculty.
You have the right to know the detailed treatment plan(s), risks, benefits and alternatives for your dental condition, including estimated costs, sufficient to give us your signed informed consent before any treatment is started. Life-preserving, emergency care could be an exception.
You have the right to refuse treatment suggested to you. In that event, you will be advised of the consequences of your decision, including the possibility that your care may be deemed a non-teaching case.
You have the right to privacy concerning your dental treatment. Discussions concerning your care will remain confidential between you, your dental student and the supervising faculty and/or appropriate staff.
You have the right to access your dental records upon request, and to have the information explained or interpreted as necessary. Your record will not be released without your written consent, except when required by law or a third-party payer contract. A fee will apply to copy your records.
You have the right to emergency care as needed. Whenever possible, your student will take care of your emergency needs.
You have a right to continuity and completion of treatment. At the completion of all active care, Quality Assurance may perform a final treatment assessment.
You are, as the patient, entitled to a safe and clean environment. This includes the expectation of compliance with infection control standards.
You have the right to schedule a recall appointment for an examination. At this appointment, the teeth are cleaned and preventive care is provided as needed. These recall procedures are provided by dental students under the supervision of faculty.
You have the right to refuse our suggested treatment plan(s), and the LECOM Dental Offices has the right not to accept you as a patient. You are then responsible for any damage to your teeth or other circumstances that result. The dental student will only provide those services that the attending faculty recommend and approve.
You have the right to prompt treatment and continuing care.
You have the right to request and examine any financial statement regarding your treatment.
You have the right to decide to participate or not participate as a subject of a research effort. Your status as a patient will not be affected by your decision.
You have the right to access a Patient Care Advocate.

Your Responsibilities as a Patient

You have the responsibility to provide, to the best of your knowledge, accurate and complete information about your present health, dental complaints, past illnesses, medications, hospitalizations, or any other matters pertaining to your health.
You have the responsibility to report any changes in your health since your last appointment to your treating dental student.
You have the responsibility to tell your dental student, if you do not understand the treatment plans developed for you, or if you do not understand the course of your treatment or what is expected of you.
You are asked to refrain from using your cell phone in the clinic during your dental appointment.
You have the responsibility to follow the recommended instructions, including home care preventive techniques and follow-up treatment given to you by your dental student or faculty member.
You have the responsibility to be respectful of others by practicing good personal hygiene and avoid the use of strong colognes, perfumes or body sprays because you will be in close physical contact with dental students, staff, and faculty.
You have the responsibility to come to your appointments on time and to be available for treatment at least once every week until your treatment is complete. If you are unable to make a scheduled appointment, please call at least 24 hours in advance.
You should not appear at the LECOM Dental Offices impaired or intoxicated. You may not bring to the School alcohol, any prescription medication that was not prescribed to you, illegal drugs, or weapons.
LECOM maintains an alcohol, drug, and tobacco-free environment. Thus, smoking and the use of alcohol or controlled substances (except as properly prescribed) are prohibited while at the LECOM Dental Offices. Also, all weapons are prohibited. These prohibitions apply to the parking lot as well.
You are responsible for asking questions when you do not understand the information or instructions.
You have the responsibility to be respectful of clinic personnel and other patients as well as clinic property. Harassment of students, faculty, staff or other patients on the basis of sex or any other protected characteristic is strictly prohibited and will result in discontinuance of treatment.
You have the responsibility to promptly pay all charges for treatment received.
You are responsible for any fees associated with weekday or weekend visits to the emergency room or emergency care centers.

LECOM Dental Offices:

4800 Lakewood Ranch Blvd., Bradenton, FL 34211, (941) 405-1600
2000 West Grandview Blvd., Erie, PA 16509, (814) 868-1001
101 LECOM Way, DeFuniak Springs, FL 32435 (850) 951-0200

*The LECOM School of Dental Medicine main campus is located in Bradenton, Florida.