Winnebago Dental Clinic Emergencies and Appointments A. Clinic Hours are Monday-Friday 8:00am-4:30pm B. Children under the age of (19) will not be seen without the consent of a parent or legal guardian. Children may be seen without the parent/legal guardian only if their treatment has been previously discussed and written approval by the parent/guardian is provided. In an emergency situation the dentist may render treatment in a reasonable manner. C. Emergencies: 1. Emergent patients are seen Monday-Friday on a first come basis at 8:00am. 2. Priority is given to those most in pain and to the scheduled patients. Emergent patients will be seen as soon as possible. D. Broken Appointment. A broken appointment is when a patient does not show or cancel their appointments. The Dental Clinic to decrease the broken appointments does send reminder cards and courtesy phone calls prior to all appointments. Three broken appointments in a one year period will result in that patient only eligible to receive emergency treatment for the following six months. Dental Eligibility The Winnebago Dental Clinic provides Direct Care and Indirect Care. Direct Care are services that we provide in the Dental Clinic such as diagnostic, fillings, cleanings, selected root canals, and extractions. The Dental Clinic gives direct care to all members of federally recognized tribes regardless of where they reside. Indirect Care is services not provided or partially provided by the Dental Clinic. Examples of this are all laboratory services (crowns, bridges, dentures), referrals (when it is a procedure we cannot do or is in the best interest to send to a specialist), and costs for Orthodontics. Funding is limited and is at the discretion of the Winnebago Tribe of Nebraska. The following restrictions apply: 1. These services are only available to an enrolled member of a federally recognized tribe residing on the Winnebago Reservation or an enrolled Winnebago Tribal member residing in the Contract Health Service Delivery Area (CHSDA). 2. Covers the emergency care of children of qualified residents who are attending school off the Reservation. 3. All members MUST have a referral from the Winnebago Dental Clinic for referral care to a specialist. Referral Dental Care A patient must first meet eligibility criteria, medical priorities, and use of alternate resources prior to consideration for referral. As the Tribe is the payer of last resort, a denial of Medicaid is required before a referral can be made. Patients may be referred if it is in the best interest of the patient and we are not able to provide that service in the Dental Clinic. Referral care is contingent on funding and to meet the following three Medical Dental priorities. A. Oral Surgery: Referrals are limited to: Broken jaws, Acute Facial Trauma, Difficult extractions (medically compromised/possible nerve damage/difficult removal), Cysts, Biopsies, Cancers, and Severe infection. NOTE: The Patient is responsible for payment of IV Sedation. B. Pediatric Care: Behavior management, Extensive treatment, and Pediatric Hospital cases may be considered for referral to a Pediatric Specialist. C. Endodontic: Complex root canals, retreatment of a prior root canal, may be referred on children 18 and below. Adults requiring molar root canal will be considered on a case by case situation. Molar endodontic are a specialty offered limited in the Dental Clinic and only teeth needed for function are considered. Second molars are not covered and the patient is financially responsible for specialist referral and care if done. Patients are responsible for any costs arising from not showing at scheduled appointments with the specialists. The Dental Clinic does not refer for any other areas including Periodontics (gum disease), Orthodontics (braces), or TMD (Joint problems). Laboratory Procedures All labs costs may be considered with priority given to Referral costs. Dental Laboratory procedures include but are not limited to: crowns, bridges, mouth guards, full dentures, treatment dentures, partial dentures, appliance therapies, and orthodontic casework. The patient is responsible for establishing and furnishing proof of referral eligibility (listed in RPMS by contract health ) in the CHSDA or will be responsible for costs. Patients requesting Dental Lab services that reside outside the CHSDA are responsible for all dental lab costs for treatment. These costs are estimated and need to be prepaid with a Money Order made out to the Winnebago Tribe of Nebraska. The goal is to regain oral function and not to provide extensive rehabilitative care. By this it is understood the Winnebago Dental Clinic will provide for eligible patients the best cost option to the clinic to restore function. Example of this is a partial denture instead of extensive crowns and bridges. Should the patient request the more costly option, they are responsible for all the Dental Laboratory costs. Esthetic laboratory services such as Veneers, Whitening of Teeth, and replacement of recent dentures are the patient’s responsibility. Orthodontics Only children (18 and below) are eligible for comprehensive orthodontics. To be eligible for braces, the child needs to have no cavities, great oral hygiene, and a desire to have braces. There is a cost of $400 for all cases. Adults may be considered only for minor orthodontics consisting of movement of a few teeth and not comprehensive treatment. Adults and patients older than 16 years may also be considered for invisible removable braces. This treatment is an alternative for some adult patients with the patient responsible for all costs. Invisible retainers’ costs range from $800 for a mild correction to $1,200 for a larger correction. Please note that we cannot treat everyone wanting braces. The demand for this service is enormous and many cases are severe and may need surgery and other specialists to correct. We are not orthodontists, but general dentists who care and work hard to offer great care and services to our patients. In all cases the Winnebago Dental Clinic strives to do our best with our resources for our patients. A person’s smile is very important. Our mouth and smile are windows to our emotions. It is how we are often perceived and judged. We are excited to provide specialized care and treatment options here that no other Dental Clinic offers. Our patients are very important to us!