Medical History Form


Download PDF

Patient Information Form


Download PDF

Financial Policy Form


Download PDF

Notice of Privacy Practice Form


Download PDF

Advance Beneficiary Notice


Download PDF

Insurance for Oral & Maxillofacial Surgery can be somewhat confusing. Some procedures are covered under both medical and dental insurance. Other procedures are strictly covered by dental plans. Many insurance companies cover the anesthesia sedation. Some do not. It would be to your advantage to acquaint yourself with your particular policy. Newer procedures in implant reconstruction are generally not covered.
In recent years managed care has replaced the traditional insurance contracts. These plans have helped to reduce the cost of healthcare, but they have also reduced access to care in some cases. Many limit the care that can be provided by an oral & maxillofacial surgeon, and all of them limit the reimbursement for their services.
We attempt to contract with as many managed care plans as possible. We participate in those managed care contracts that reimburse our procedures at a fair rate to compensate for the quality of our facility. We are doing our part to keep surgical fees as low as possible. By providing out- patient facilities, we can accomplish approximately 90% of our procedures without the expense of a hospital setting. By doing this, we can save insurance carriers and our patients hundreds of thousands of dollars each year.
Financial Arrangements
For our patients that have insurance plans that do not cover their services completely or for patients who do not have insurance, we have developed an alternative financial plan. Payments plans may be arranged by our business office by calling (865) 981-2012 or (800) 879-3982. We also accept MasterCard, Visa, and Discover credit cards.

Universal Precautions are recommended by The Centers for Disease Control in Atlanta. By following these guidelines, the possibility of passing a disease from one patient to another is eliminated. Following Universal Precautions means we treat all patients as though they may be potentially infectious. These same precautions prevent the possibility of transmitting a disease from our surgical staff to a patient also.

We protect you in many different ways including:

Use of disposable products whenever possible
Equipment designed to prevent contamination
OSHA approved methods of disposal of contaminated waste
Disinfecting of contaminated surfaces with approved solutions
Care and maintenance of safe water supply lines
Hand washing
Gloves to prevent direct contamination as well as cross-infection
Protective eyewear
Vaccination of surgical staff
Cleaning and steam sterilization of instruments