Patient Information

Initial ConsultationAppointmentsFinancial & Insurance InformationPreliminary PaperworkPrivacy Policy & HIPPAPost Treatment Care

Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. In many cases, root canal treatment can be performed during the initial appointment. A need for surgery, a complex medical history, or treatment plan will usually require an evaluation and a second appointment for treatment.

Please assist us by providing the following information at the time of your consultation:

• Your referral slip and any radiographs (X-rays) if applicable

• A list of medications you are presently taking

• Any other information you feel will help us in providing you with the best possible treatment

• From this website, you may also print and bring the Preliminary Paperwork with you to your appointment.

• If you have dental insurance, please bring the necessary completed forms. This will save time and allow us to help you process any claims.

IMPORTANT: All patients under the age of 18 must be accompanied by a parent or guardian for each visit to our office.

If you have a medical condition, are taking any medication whether prescription, over-the-counter, herbals, or nutritional supplements, or your medical status has changed since your last appointment, please alert us during the consultation or prior to beginning treatment. If you need antibiotic pre-medication, please contact us the week before you are scheduled for treatment.

Our office is open Monday through Thursday from 8:00 am until 4:00 pm and Friday 8:00am until 12:00 Noon. We will schedule your appointment as promptly as possible. If you have an emergency, every attempt will be made to see you as soon as possible.

We try our best to stay on schedule to minimize your waiting; however, various circumstances may lengthen the time allocated for a procedure. Emergency cases can arise and cause delays. We appreciate your understanding and patience.

Please contact our office at 402.486.4380 with any questions or to schedule an appointment.

For your convenience we accept cash, check, and the following credit cards: Visa, MasterCard and Discover. We also accept Care Credit.

If you have questions regarding payment, please contact us at 402.486.4380.

Insurance Information

This section of our web site provides information about dental insurance benefits. We want you to understand how dental insurance works and how to make it work best for you. You should also understand how the treatment Dr. Vanicek provides works with your dental plan. Lincoln Endodontics is a preferred provider for Ameritas, Blue Cross Blue Shield, and Delta Dental of Nebraska.

The contract your employer negotiated with your insurance carrier defines your dental benefits. Please read the benefit or insurance plan booklet provided by your employer so that you better understand your benefits. Various dental plans cover endodontic procedures at different payment levels and, as a result, your payment portion may vary. If you do not find the answers to your questions, contact your employer’s plan or benefits administrator who can explain the details.

At Lincoln Endodontics we work hand in hand with you to maximize your insurance reimbursement for covered procedures. As a courtesy, we obtain insurance information and confirm eligibility prior to your visit, and will file the claim as a service for you. Most insurance companies will respond with payment within six weeks. A standard treatment fee, based on the procedure(s) performed, will be collected at the time services are rendered. This may or may not be the same as your insurance co-pay, or the non-covered portion of the procedure.

If you have any problems or questions, please ask our staff. They are well informed and up-to-date. They can be reached by phone at 402.486.4380.

The following is a Patient Information form in Adobe PDF format. If you do not have the ability to open PDF documents, please download Adobe Acrobat Reader and install it.

You may download, complete, and print the following forms and bring them with you on the day of your appointment.
Patient Consent Form
Financial Policy Form
Medical History Form
Patient Registration Form

NOTICE OF PRIVACY PRACTICES

This notice describes how health information about you may be used and disclosed and how you can get access to this information.

Please review it carefully. The privacy of your health information is important to us.

OUR LEGAL DUTY

We are required by applicable federal and state law to maintain the privacy of your health information. We are also required to give you this Notice about our privacy practices, our legal duties, and your rights concerning your health information. We must follow the privacy practices that are described in this Notice while it is in effect. This Notice takes effect 08.24.06, and will remain in effect until we replace it.

We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for all health information that we maintain, including health information we created or received before we made the changes. Before we make a significant change in our privacy practices, we will change this Notice and make the new Notice available upon request.

You may request a copy of our Notice at any time. For more information about our privacy practices, or for additional copies of this Notice, please contact us using the information listed at the end of this Notice.

USES AND DIDSCLOSURES OF HEALTH INFORMATION

We use and disclose health information about your for treatment, payment, and healthcare operations. For example:

Treatment: We may use or disclose your health information to a physician or other healthcare provider providing treatment to you.

Payment: We may use and disclose your health information to obtain payment for services we provide to you.

Healthcare Operations: We may use and disclose your health information in connection with our healthcare operations. Healthcare operations include quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing or credentialing activities.

Your Authorization: In addition to our use of your health information for treatment, payment or healthcare operations, you may give us written authorization to use your health information or to disclose it to anyone for any porpoise. If you give us an authorization, you may revoke it in writing at any time. You revocation will not affect any use or disclosures permitted by your authorization while it was in effect. Unless you give us a written authorization, we cannot use or disclose your health information for any reason except those described in this Notice.

To Your Family and Friends: We must disclose your health information to you, as described in the Patient Rights section of this Notice. We may disclose your health information to a family member, friend or other person to the extent necessary to help with your healthcare or with payment for your healthcare, but only if you agree that we may do so.

Persons Involved in Care: We may use or disclose health information to notify, or assist in the notification of (including identifying or locating) a family member, your personal representative or another person responsible for your care, of your location, your general condition, or death. If you are present, then prior to use or disclosure of your health information, we will provide you with an opportunity to object to such uses or disclosures. In the event of your incapacity or emergency circumstances, we will disclose health information based on a determination using our professional judgment disclosing only health information that is directly relevant to the person’s involvement in your healthcare. We will also use our professional judgment and our experience with common practice to make reasonable inferences of your best interest in allowing a person to pick up filled prescriptions, medical supplies, x-rays, or other similar forms of health information.

Marketing Health-Related Services: We will not use your health information for marketing communications without your written authorization.

Required by Law: We may use or disclose your health information when we are required to do so by law.

Abuse or Neglect: We may disclose your health information to appropriate authorities if we reasonable believe that you are a possible victim of abuse, neglect, or domestic violence or the possible victim of other crimes. We may disclose your health information to the extent necessary to avert a serious threat to your health or safety or the health of safety of others.

National Security: We may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. We may disclose to authorized federal officials health information required for lawful intelligence, counterintelligence, and other national security activities. We may disclose to correctional institution or law enforcement official having lawful custody of protected health information of inmate or patient under certain circumstances.

Appointment Reminders: We may use or disclose your health information to provide you with appointment reminders (such as voicemail messages, postcards, or letters).

Patient Rights Access: You have the right to look at or get copies of your health information, with limited exceptions. You may request that we provide copies in a format other than photocopies. We will use the format you request unless we cannot practicably do so. (You must make a request in writing to obtain access to your health information. You may obtain a form to request access by using the contact information listed at the end of this Notice. We will charge you a reasonable cost-based fee for expenses such as copies and staff time. You may also request access by sending us a letter to the address at the end of this Notice. If you request copies, we will charge you $.25 for each page, $25 per hour for staff time to locate and copy your health information, and postage in you want the copies mailed to you. If you request an alternative format, we will charge a cost-based fee for providing your health information in that format. If you prefer, we will prepare a summary or an explanation of your health information for a fee. Contact us using the information listed at the end of this Notice for a full explanation of our fee structure).

Disclosure Accounting: You have the right to receive a list of instances in which we or our business associates disclosed your health information for purposed, other than treatment, payment, healthcare operations and certain other activities, for the last 6 years, but not before April 14, 2003. If you request this accounting more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding to these additional requests.

Restriction: You have the right to request that we place additional restrictions on our use or disclosure of your health information. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in an emergency).

Alternative Communication: You have the right to request that we communicate with you about your health information by alternative means or to alternative locations. (You must make your request in writing). Your request must specify the alternative means or location, and provide satisfactory explanation how payments will be handled under the alternative means or location you request.

Amendment: You have the right to request that we amend your health information. (Your request must be in writing, and it must explain why the information should be amended). We may deny your request under certain circumstances.

Electronic Notice: If you receive this Notice on our website or by electronic mail (e-mail), you are entitled to receive this Notice in written form.

Congratulations! By saving your tooth with root canal treatment, you have made a significant step towards better oral health.

This guide is intended to answer questions you may have about the post-operative period and to give you information on how to preserve the health of your tooth following root canal treatment.

What should I expect following endodontic treatment?

The root canal system inside your tooth has been thoroughly cleaned, and the irritated tissue and bacteria that have caused you to need root canal treatment are gone. It is normal to feel some tenderness in the area over the next few days as your body undergoes the natural healing process. You may also feel some tenderness in your jaw from keeping it open for an extended period of time. These symptoms are temporary and usually respond very well to over-the-counter pain medications. It is important for you to follow the instructions on how to take these medications. Remember that narcotic medications, if prescribed, may make you drowsy, and at least eight hours should pass prior to operating dangerous machinery or driving a car after taking them. Your tooth may continue to feel slightly different from your other teeth for some time after your root canal treatment has been completed. However, if you have severe pain or pressure that lasts more than a few days, contact our office.

Guidelines for Post-Treatment Care

• Do not eat anything until the numbness in your mouth wears off. This will prevent you from biting your cheek or tongue.

• Do not chew or bite on the treated tooth until you have had it restored by your dentist.

• Be sure to brush and floss your teeth as you normally would.

• If the opening in your tooth was restored with a temporary filling material, it is not unusual for a thin layer to wear off in-between appointments. However, if you think the entire filling has come out, contact your endodontist.

• Contact your endodontist right away if you develop any of the following:

• A visible swelling inside or outside of your mouth

• An allergic reaction to medication, including rash, hives or itching (nausea is not an allergic reaction)

• A return of original symptoms

• Your bite feels uneven

Taking Care of Your Tooth
Root canal treatment is only one step in returning your tooth to full function. A proper final restoration of the tooth is extremely important in ensuring long-term success. Contact your dentist within two weeks to arrange your next appointment. If your tooth is being treated in more than one visit by an endodontist, do not return to your dentist for the final restoration until the root canal treatment is completed.

What the Future Holds

The tooth that has had appropriate endodontic treatment followed by a proper restoration can last as long as your other natural teeth. After the tooth has been restored, you need only practice good oral hygiene, including brushing, flossing, regular checkups and cleanings. Your dentist or endodontist may periodically x-ray the tooth to ensure that healing has occurred. Occasionally, a tooth that has undergone endodontic treatment does not heal or pain continues. At times, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, repeating the endodontic procedure can save the tooth.

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