DENTAL HEALTH
The dental clinic at More Smiles Wisconsin (MSW) provides a range of services to patients who qualify. Please check below to see if you are eligible. If you would like assistance call (608) 665-2752. Our mission is to provide services to those who may struggle to find coverage due to income, type of insurance, or lack of insurance.
If you have pain, swelling, difficulty eating, or other urgent dental needs, you can schedule an emergency appointment at More Smiles throughout the week or at our Thursday night emergency clinic by calling 608-665-2752.
PATIENT ELIGIBILITY
Patients must meet the below qualifications in order to get services at More Smiles Wisconsin. If you need assistance determining your eligibility, please call us at (608) 665-2752.
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Live in one of these counties: Dane, Columbia, Dodge, Green, Iowa, Jefferson, Richland, Rock, Sauk, or Walworth. Residents of other counties can call us to confirm eligibility: (608) 665-2752.
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Have Medicaid and BadgerCare insurance, OR have no insurance. We do not accept any other forms of dental insurance.
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If you have no insurance, your income must be at or below 200% of the Federal Poverty Level for your family size (about $32,000 per year for an individual or $66,000 for a family of four). See Income chart below (from the Wisconsin Department of Health website).
FEDERAL POVERTY LEVEL CHART
If uninsured, you will be asked to furnish proof of financial eligibility. Examples of documents that can be used to verify income include:
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Pay stub from employer
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Social Security statement
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Unemployment/Worker’s Compensation statement
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Most recent tax return (1040)
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Child support statement
MAKE AN APPOINTMENT
To become a new patient at MSW, please call 608-665-2752 to schedule your initial appointment. Please be prepared to provide some information about yourself including insurance status, family size, and household monthly income to help our care coordinator determine your eligibility and copay amounts.
FEES FOR DENTAL SERVICES
Out-of-pocket costs are due at time of appointment. This includes co-pays associated with certain Medicaid plans. We accept cash and debit/credit card payments.
If you are uninsured, we offer a sliding fee scale for dental services as follows:
PATIENT RULES AND POLICIES
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I acknowledge that I have received a copy of MSW’s Notice of Privacy Practices.
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I understand that is my responsibility to clarify if I have co-pays and balances prior to appointments
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I understand that co-pays are due at the time of service unless other payment arrangements have been made in advance with MSW staff.
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I understand that if my insurance denies my coverage I am responsible for the full costs of the treatment I received (will receive), at MSW as determined by sliding scale fees.
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I understand that I am responsible for reporting phone number or address changes to MSW staff.
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I understand that if I do not confirm an appointment 24 hours before or do not leave a message, that appointment could be cancelled by MSW due to extreme need and limited availability of dental appointments.
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I understand that if I fail twice to show up for general/hygiene appointments or once for a root canal without 24-hour notice to MSW, I will be discharged from the program and cannot reapply for one year (except in the case of an emergency).
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I understand that if I fail to keep an appointment due to an emergency, I can bring in appropriate documentation which will keep me admitted into the program.
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I understand that if I arrive more than 10 minutes late for an appointment without notifying MSW staff, my appointment will be marked as missed and I will not be seen that day.
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I understand that MSW may use my information in order to apply for funding that supports the clinic.
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I understand that I must conduct myself in a civil and respectful manner to MSW and Salvation Army staff. If I do not, I will be asked to leave the clinic and permanently discharged from the program.