This is how we work.
What to expect when you visit our practice.
Welcome to Eden Dental Centre. We all understand the stresses and unwillingness to pay the dentist a visit, but in light of this coupled with the complex and diverse medical aid and insurance structures, Eden Dental centre and it’s staff would like to make the experience as friendly, comfortable , informative and as professional as possible. In order to achieve this we have put together some of our rules, regulations and systems on how we operate.
- HPCSA –Health Professions Council of South Africa
- SADA – South African Dental Association.
The following has been clarified from The HPCSA & SADA:
- The patient information sheet must be completed “IN FULL” and must be updated at all times should something on your side change. The practice cannot treat the patient for medico-legal reasons before this has been done.
- There is no contract or relationship between practitioners and medical schemes except managed care arrangements.
- The responsibility for obtaining authorisation for treatment or services lies with the patient.
- Patients are reminded that it is their responsibility to ensure that authorisation is obtained from medical schemes before treatment or services will be rendered.
- Patients should also inform practitioners if there are limitations to the authorisation provided.
- Although practitioners help their patients obtain authorisation, it is still the patient’s responsibility for obtaining authorisation.
A large portion of discontent arises from misunderstanding as to what the 3rd party funders [medical aids and medical insurances] cover as well as understanding the claiming and payment systems and methods. In order to facilitate a better understanding of our practice we have put together some pertinent facts on how we function.
DOWNLOAD SADA COMMUNIQUE 2016.002 – HPCSAObtaining Medical Aid Authorisation, Patients’
- By and large we charge the respective medical tariffs for ordinary dentistry. This includes restorations [fillings], check –ups, x-rays, etc.
- The medical aids have for the past few years increased their rates by 5-6 % P/A which comes into effect on 1st January every year. Every medical aid has different rates for the same work and materials that we use on our patients. Due to the continuous decline of the South African Rand against all major currencies, the current volatility of the Rand & double digit medical inflation, there are certain procedures which necessitates a rate over and above the medical aid rate. Another reason is that the specialised procedures with our cost of operation and materials often results in a loss if we charge the medical aid rate.
- Our Specialised Dentistry which includes Crowns, Bridges, implants, all denture work , cone beam scans (3 –D scans) and recently root canal treatment will be charged out at a higher rate. In all instances all Specialised Dentistry must be accompanied by an estimation where the medical aid rate will be shown, and the excess will be shown in the balance column. Please note the excess is only charged on the actual specialised dentistry and not on the rest of the materials and sundries.
It is expected that the patient will send this estimation onto their medical aid which will not only notify the medical aid of the treatment required, but they can notify you the patient of your benefits that will be covered.
Payments & Accounts
The practice does on most occasions submit the accounts for your convenience, however there are certain instances where your medical aid will not pay for certain procedures or treatment according to their RULES AND REGULATIONS and benefit structures and plans. PLEASE ENSURE THAT YOU UNDERSTAND YOUR DENTAL BENEFITS. This has to do with their business plan and models and NOT with our treatment plan. WE CANNOT TREAT the PATIENT ACCORDING to what the THIRD PARTY FUNDERS are or are not prepared to pay for.
Once we submit your account your medical aid will send you a breakdown of the account, as will the practice. Any shortfalls [for whatever reason] will be followed up with a phone call or an sms or whatsapp advising you of the shortfall. Our accounts are strictly 30 days from the time of treatment. Please respect our rules, as should the accounts not be settled, the outstanding balance will be handed over to a collection agency and ALL COSTS associated with the agency or attorneys will be for the patients account.
Our staff are friendly and well trained and have a wealth of experience. Please treat them with the same courtesy and respect that you would expect from us. We will not tolerate ABUSE whilst attempting to sort and explain your predicament. They will endeavour (where possible) to help and guide you through your queries. They cannot be held responsible for understanding your medical aid, nor are they qualified Dentists. [consult your dentist for dental matters].
General House Rules
- Should the dentist run late, please bear with us. You will be attended too. In many instances there might be a problem with the patient’s tolerance levels, the anaesthetic or just a difficult case where more time is required to deliver quality treatment. Often a patient who has had a problem getting to us on time [family emergency or traffic] can cause the dentist to run late the entire day. Please try and understand that it could be you one day.
- Even with 4 dentists [soon to be 5], it may happen that you require an emergency. The practice will not turn away any emergency, but to be fair to the patients who have booked in advance, you may be required to wait in our reception area until one of the Dentists have a gap to attend to you.
- The practice, where possible will have at least 2 dentists on duty at all times within our working hour schedules. Mon. – Fr. 7h30 to 17h00 and Sat. 7h30 – 13h00.
For those times where unexpected pain arises there is an emergency number where you can phone through to. It might be a telephonic consultation, or in the extreme case a dentist will be called out. Should this happen a call out fee will be billed over and above the normal rates for any treatment rendered. This call out fee will need to be settled in cash or by card. The balance will be sent to your funder. In the case of a private patient or if you are on a hospital plan you may be required to settle in full at the time of the treatment.
Please understand that it takes a lot of time to open and set up the practice in the case of an emergency, couple with the fact that the dentist does have a life and emergencies usually occur on public holidays and after a hard day’s work. Respect and attend the appointment timeously.
Appointments not kept [ANK] or missed appointments
Please be considerate in keeping to your appointments. We fully understand the turmoil of life, and we even sympathise with “ I completely forgot”, but please understand that not keeping an appointment takes the time away from another deserving patient.
We appreciate it if you can notify us as soon as possible.
Eden Dental Centre reserves the right to charge for missed appointments on a half hourly rate determined annually. ( please ask us for this rate should you be interested). Should a patient arrive late, we reserve the right to cancel and reschedule an appointment should there be too little remaining time left to complete your procedure. Please do not take this out on the staff, after all it is NOT THEIR DOING.