Special personal note: Please read carefully:
The relationship between a patient and a health care professional is founded in trust and mutual respect. This relates not only to on-going clinical care and outcomes over the years but also to the financial aspects of dental treatment. Advanced dental treatment of the standard provided at LCIAD can require considerable investment. It is inherently costly to provide to the standards that we insist upon in the environment in which it is provided. Significant financial outlay may be involved for any given treatment by both parties. It is in the interest of our patients that any appropriate treatment required is carried out to as high a standard as can be achieved in a timely fashion. We therefore keep fees as reasonable as circumstances allow and offer payment plans for extensive courses of treatment. It is in the interest of our patients and the reputation of LCIAD and all who work here that you are delighted with your treatment and care at this practice and the long-term value provided by our attention to detail and quality. We undertake to treat you with every good will and to the best possible standards set by our profession and my personal ethos as Clinical Director of LCIAD. Nevertheless, based on our experiences, it has become necessary for LCIAD Ltd to include the following clauses in our correspondence to clarify clinically and financially what each party may reasonably expect of the other for a given course of treatment. Terms and conditions are updated over time, but the following will apply to your course of treatment and are valid for this correspondence only. Please read these terms carefully.
Dr Koray Feran BDS MSc FDSRCS – Principal Dental Surgeon and Clinical Director
The London Centre for Implant and Aesthetic Dentistry Ltd (LCIAD Ltd Company No. 6639132 Reg. 07/07/2008)
Terms and Conditions (2020a)
These Terms and Conditions relate to all patients attending The London Centre for Implant and Aesthetic Dentistry (LCIAD) Limited for dental care and all patients attending LCIAD Face for Facial Aesthetics where indicated. LCIAD Face is the Facial Aesthetics centre at LCIAD Ltd and operates as part of LCIAD Ltd. The term LCIAD in this document implies LCIAD Ltd and LCIAD Face.
General policy, consultations, reports and medicolegal obligations
1. These terms and conditions should be read in conjunction with the accompanying Preliminary (PDR), Updated (UDR), Specialist (SDR) or Full (FDR) Dental Report, Treatment Plan and Estimate correspondence or Facial Aesthetics Report (FAR), Treatment Plan and Estimate correspondence as applicable.
2. All New Patient Consultations are payable in full in advance when the appointment is booked. The current fee for this is £400. Specialist Periodontal or Facial Aesthetics consultations are chargeable at £250.
3. IMPORTANT: All patients attending LCIAD will be asked to fully complete a confidential and comprehensive Medical and Dental Questionnaire (MDQ) online prior to your initial consultation. Parents or guardians should complete the MDQ for minors under the age of 18. Those attending only for Facial Aesthetics at LCIAD Face will be asked to complete a confidential and comprehensive Medical and Facial Aesthetics Questionnaire (MFAQ). This questionnaire will be updated at each visit to ensure that we always have your most up -to-date details. Your medical condition may adversely affect or be affected by dental treatment and facial aesthetics treatment and it is important that the questionnaire is completed in full and received no less than 48 hours prior to your consultation. This allows the clinician looking after you to study your history and individual concerns and requirements in advance of your consultation to optimise your care at LCIAD. This questionnaire is an indispensable part of your patient record and our medico-legal obligations to you. We reserve the right to postpone your consultation appointment with loss of your deposit or we may require additional consultation time at additional cost to you if this completed questionnaire is not received in time.
4. All patients attending LCIAD for a New Patient Dental Consultation will undergo a full and comprehensive dental examination including necessary radiographs and photographs and occasionally video even if you have your own dental surgeon. This is the policy of LCIAD Ltd and our medicolegal obligation to ensure that no aspect of your dental or medical condition that may have a bearing on the success of your treatment or future health are missed, even if seemingly unrelated to your current condition. Patients attending for Specialist Periodontal consultations only when under the care of another referring dental surgeon in charge of their regular care will receive a periodontal examination only. All patients attending LCIAD Face for a facial aesthetics consultation will undergo a full and comprehensive facial aesthetics examination including necessary photographs and occasionally video. You may indicate on your MDQ / MFAQ how you consent to these images being used in line with current GDPR regulations.
5. New patients attending as an emergency will have their emergency treatment prioritised and be encouraged to return for a full New Patient Consultation for further examination. Such emergency appointments will be payable at normal hourly rate as indicated under item 12 below on the day of the emergency appointment. An additional callout fee commensurate with travel time may be applied at our discretion outside hours, on weekends or public holidays. Clinicians at LCIAD are under no obligation to see emergency patients that are not registered patients of LCIAD. LCIAD recognises an emergency as being one or more of the following: persistent pain unresponsive to painkillers, persistent bleeding, infection or swelling especially if accompanied by an elevated temperature or breathing difficulty, trauma or accident and breakage or loss of a front tooth or restoration. Emergency treatment may be provided only to resolve the current emergency outside normal working hours and is at the discretion of the clinician. It may not be possible to provide emergency cover in the absence of nursing or chaperone support outside working hours.
6. All patients attending LCIAD Face for a Facial Aesthetics consultation will undergo a full and comprehensive facial aesthetic evaluation and examination including necessary photographs. Patients attending only for facial aesthetics consultations and treatments at LCIAD Face as part of LCIAD Ltd will be required to complete a signed statement to indicate that they do not wish for LCIAD to carry out a dental examination or take responsibility for their dental care. There is no obligation for patients attending LCIAD Face to be patients of the dental care side of LCIAD Ltd. However, this also means that we are unable to look after or take responsibility for your dental care needs unless you specifically request us to do so later in writing. If rectification of dental work is integral to your treatment requirements for Facial Aesthetics, then a full dental examination as indicated under item 4 above will normally be recommended but without obligation.
7. After your consultation we will send you a Preliminary Dental Report (PDR) or Facial Aesthetics Report (FAR) with a summary of our significant findings and recommendations and an estimate range outlining the scope of treatment required. Due to medicolegal requirements, for all but the most straightforward of treatment plans, it is normally necessary to provide you with a full dental report (FDR) of your current condition. This will include a detailed report of your current condition with photographs and x-rays, detailed treatment options, a detailed treatment plan, schedule and phased estimate. Your signed consent to the proposed plan for your care will be required prior to any non-emergency treatment commencing. Each FDR is custom written for each patient outside clinical practice hours and can take 3-4 hours to complete outside normal surgery hours. This report is chargeable separately based on time taken to prepare at a professional rate of £200 per hour and is payable in advance based on the estimate in your Preliminary Dental Report (PDR). All information pertinent to your case will be included in the Full Dental Report (FDR) correspondence and refers to the discussions and findings at the consultation appointment(s) and any subsequent additional investigations. You should question any aspect of your plan that is unclear to you in writing and receive a written explanation. It is the patient’s responsibility to ensure they understand what is being proposed prior to commencement of treatment or at any stage during treatment and to request further information in writing if anything is unclear. If a Full Dental Report is requested at the time of initial consultation instead of a Preliminary Dental report, a 50% fee reduction is available due to additional time saved.
Financial aspects and fee structure
8. All estimates are custom written based on individual patients’ requirements and are calculated from detailed planning of your case. Estimates are valid for 3 calendar months from the date of this correspondence. All fees other than hygienist visits, examination visits and emergency appointments are payable in advance in phases outlined in your Treatment Plan and Estimate Summary – Finance Options Form. Examination, hygienist and emergency appointment fees are payable in full on the day of the appointment.
9. Where this 3-month period overlaps a date of fee revision at the practice, we will honour the original estimate if treatment commences and proceeds within the prescribed timescale and the estimate for each phase or the whole treatment plan estimate is paid in full in advance.
10. All written estimates paid in full in advance of treatment commencing are subject to a 7.5% discount on treatment plans of £10,000 and above only. No discount is applicable on courses of treatment paid for by third-party finance.
11. If the treatment has been paid for in advance but the treatment cannot be completed by either party, any credit remaining shall be refunded within 3 calendar months of such notice being given in writing. This period is to ensure that any additional emergency or remedial work that may be required by the patient in this period is covered if a plan is discontinued. Any discount previously applied for a greater sum will be recalculated based on treatment already invoiced. No interest will be payable on this refunded sum.
12. Appointments not kept or cancelled without the notice period outlined in the table below are chargeable at our discretion up to the current full hourly cancellation rate as below:
• Dental surgeon £660 per hour
• Facial Aesthetics LCIAD Face £560 per hour
• Hygienist / Therapist services £168 per hour
Please note that this is a cancellation fee that covers our overheads and should not be used to calculate treatment fees which are estimated in your report and estimate. This fee does not cover third party cancellation fees that may be charged by anaesthetists which would be payable separately where applicable.
13. The hourly fees are set and periodically revised based on the coverage of treatment cost overheads and level of treatment. They are subject to revision and the updated fees may be found on the LCIAD website. For cancellation of appointments without charge we require the following cancellation notices:
Appointments up to 2 hours 2 full working days Full working days mean 9.00 am until 5.00pm Monday to Friday where the practice is open. (Please note LCIAD is closed between Christmas Day and New Year’s Day inclusive so any cancellations for early January appointments should be made before Christmas with the appropriate notice)
Appointments 2-3.5 hours 3 full working days
Appointments over 3.5 hours 5 full working days
Block-booked series of appointments Each separate appointment will be subject to the terms above based on time of cancellation
No late cancellation charge will be made for time that can be filled by re-appointing other patients so the more notice you are able to give, the less likely we are to have to invoice you for a late cancellation. No fees will be incurred for genuine illness for the first appointment missed in any calendar year up to a period of 2 hours. We reserve the right to charge for lost time if an appointment of more than 2 hours is cancelled at short notice due to ill health or there are 2 or more cancellations or non-attendances due to illness in any 12-month period at our discretion.
14. Where ¼ or more of the appointment time has been lost due to lateness of attendance, we reserve the right to re-schedule appointments and charge up to full hourly clinician rate for the appointment time lost at our discretion. This is to have to avoid rushing work and the knock-on effect throughout the day on other scheduled appointments or the effect this may have on having to reschedule a series of appointments.
15. In the event of erratic or unreliable attendance or if there are 3 or more late cancellations or late attendances in any 12-month period we reserve the right to request full payment of all fees for the entire course of treatment in advance at our discretion prior to scheduling further appointments. We reserve the right to temporarily or permanently withdraw services at the discretion of the clinician in charge of your care and the Clinical Director without further obligation or acceptance of responsibility for direct or indirect consequences of postponing treatment. Late cancellations and non-attendances will be invoiced against advance payments and a statement sent to you by email each time a charge has been made. A 7.5% discount will be applicable as per Item 3 above if full payment has been made in advance. Subsequent payments towards continuing treatment will need to be made in full in advance of each phase if your credit balance is reduced through non-attendance or late cancellation.
Estimates and guarantees
16. Due to the complexity of some courses of treatment, it may not be possible to give an accurate estimate of fees at the start of treatment until some investigative procedures are carried out first and the response to initial treatment evaluated. Such estimates will then necessarily need to be staged or phased. You will be informed in writing as soon as possible if the treatment costs are likely to exceed or fall below the estimate(s). An estimate of further investigations required will be made in your Preliminary Dental Report or Full Dental report as appropriate.
17. Estimate ranges given on preliminary reports may be subject to written confirmation with a full dental report, treatment plan and estimate for which a separate fee is payable. Please note that the estimates are not definitive quotes and may vary up or down during a course of treatment. Payments of fees towards treatment must follow the treatment phases indicated on your Treatment Plan and Estimate Summary – Finance Options Form and are based on treatment proceeding to the prescribed timescale. Occasionally we may complete treatment for a lower fee than initially predicted. Additional fees are likely to be incurred if you delay treatment beyond the recommended timescale or further time or expense is incurred in completing your case due to delay or if your case proves to require significantly more time or expense to complete than first predicted. The appropriate party will complete balancing payments within 14 days after the end of the relevant phase of treatment.
18. LCIAD and the dental technicians with whom we work guarantee our work against technical failure for 5 years. This guarantee commences from the End of Treatment Review Appointment. The End of Treatment Review Appointment must be within 2 working weeks of final fitting to ensure that all aspects of the work have had time to settle and have been adjusted to the satisfaction of the clinician when the patient is not under the influence of local anaesthetic or sedation. “Technical failure” will be diagnosed and photographically documented by the dental surgeon and the information shared with the dental technician responsible for any laboratory work fitted. It will cover the following:
• Breakage of definitive restorations, (but not core restorations prescribed for crowning).
• Definitively fitted or cemented laboratory work (apart from the acrylic or composite resin veneering on metal framework implant bridges or attachment or retention components in removable dentures which will require servicing as teeth or attachment or retention elements wear).
• Breakage of implantable medical devices such as dental implants or manufactured components
The guarantee does not cover:
• Minor wear, chipping or cracking of laboratory work over time from normal usage where the core material or tooth has not been visibly exposed.
• Temporary emergency care items such as temporary repair of breakages or treatment to alleviate an emergency situation.
• Integrity of provisional restorations if definitive replacement is delayed by more than 2 months beyond that advised or planned.
• Where a guarantee has not been given in the treatment planning letter for a specific reason or for a specific item or items of treatment. The reasons for this will be given in the dental report.
• Where there has been a lack of proper cleaning and home care, lapse in recommended examination and hygienist programme visits, breakage due to trauma, inappropriate use or suspected deliberate damage, delay in the provision of definitive protective restorations beyond a period of 2 months from when recommended, new decay, gum recession exposing edges of crowns or implants, periodontal (gum) infection or sudden tooth or root fracture under an intact restoration.
• Subjective unacceptability from the viewpoint of the patient or third party including their partner or spouse if work is technically correct and the patient has accepted cementation or fitting at the time of the fit appointment.
19. LCIAD also covers the following biological failures. Biological failure includes the following:
• Complete failure of bone grafts or soft tissue grafts or dental implants in non-smokers, patients not taking bisphosphonate or other bone metabolism-influencing medication and not having any disease process influencing bone or soft tissue healing including but not limited to diabetes, high LDL cholesterol and low vitamin D levels only. We may require you to have blood tests via your GP or The Doctors Laboratory in Wimpole Street if we suspect a systemic cause to any failures. These costs would not normally be covered by LCIAD. We may request appropriate blood tests if you have a history of biologic failure of previous treatments.
• Failure of root canal treatment by persistent infection but not including breakage or root fracture under a crown or due to a delay in protective crowning or onlaying for protection when recommended.
Work is guaranteed as follows:
Failure < 1 year Work will be repaired or replaced free of charge, or fee paid for failed work will be deducted from further work whichever is applicable. Refunds will not be made.
Failure 1-2 years Work will be repaired or replaced at 20% of current cost, or 80% of fee paid for failed work will be deducted from further work whichever is applicable. Refunds will not be made.
Failure 2-3 years Work will be repaired or replaced at 40% of current cost, or 60% of fee paid for failed work will be deducted from further work whichever is applicable. Refunds will not be made.
Failure 3-4 years Work will be repaired or replaced at 60% of current cost, or 40% of fee paid for failed work will be deducted from further work whichever is applicable. Refunds will not be made.
Failure 4-5 years Work will be repaired or replaced at 80% of current cost, or 20% of fee paid for failed work will be deducted from further work whichever is applicable. Refunds will not be made.
Failure > 5 years Full fee applicable or deduction in current fee will be applied at the discretion of the Clinical Director
20. All patients attending LCIAD Face for a course of treatment will receive a customised maintenance plan to maintain the result where treatment has a finite expectation of effective duration. This is normally payable in advance at the end of treatment and scheduled in accordance with the advice of your clinician. This does not cover additional treatments which would be estimated for separately upon request.
21. Any areas of dispute may be referred for independent arbitration with the professional indemnity society of the clinician concerned. Details of the clinician’s professional indemnity society can be requested from the Practice Manager Zoe Harmer by emailing email@example.com.
22. The guarantees are conditional on you receiving at least 1 clinical dental examination at LCIAD Ltd per calendar year and at least 4 hygienist visits per calendar year or as specifically recommended to you in your correspondence or subsequent dentist or hygienist/therapist advice during review or examination appointments. LCIAD Ltd is not responsible for the quality of hygiene services provided by other practices. Inadequate or infrequent hygienist care may negate your guarantee and our recommendation is that hygiene services are provided and documented at LCIAD Ltd to maintain this guarantee unless alternative hygienist services can demonstrate documented care to the same standard. Your End of Treatment Review discharge letter will outline the recommendations for ongoing hygiene care if you attend hygiene visits at another practice. This would include regular recordings of plaque, bleeding, pocketing and recession scores and additional photographs and radiographs as appropriate and as prescribed by LCIAD. Allowances may be made for exceptional circumstances at our discretion.
Clinical records and consent
23. All original material and digital dental records, laboratory work, photographs, video or patient data recorded on any medium remain the property of LCIAD Ltd and may be used anonymously and within the constraints of the current General Data Protection Regulation (GDPR) from 25th May 2018 which supersedes the Data Protection Act 1998 (ICO Registration Number: Z1948341 – LCIAD Ltd.) for professional teaching or promotional materials including but not restricted to national and international teaching, lecturing, mentoring, publishing, brochures and websites unless you inform us otherwise in writing or on your initial patient questionnaire.
24. Photographs and video are taken routinely as part of your clinical record and it is not acceptable for us to work without this documentation. Copies of all photographs and X-rays and CT scan screenshots are included as part of your PDR or FDR and estimate.
25. The Treatment Plan and Estimate Summary – Finance Options Form and Patient Consent and Declaration Form included in your PDR or FDR must be completed and digitally signed using Adobe Sign in all cases to minimise risks of any misunderstanding prior to treatment commencing. Agreeing verbally, booking a treatment appointment and / or completing and signing the enclosed Treatment Plan and Estimate Summary – Finance Options Form and Patient Consent and Declaration Form in the accompanying treatment plan implies that you have read, understood, accept and agree to abide by these terms and conditions as they apply to this course of treatment and that all your questions regarding the proposed treatment have been answered to your satisfaction in writing.
26. Attendance for a scheduled treatment visit following receipt of this correspondence and payment for your next phase of treatment implies consent to commencing treatment as proposed in the latest correspondence and report sent by LCIAD and to settling associated fees as per these terms and conditions if no other communication is received in writing or by e-mail from you prior to the treatment appointment. LCIAD Ltd reserves the right to postpone treatment without obligation or liability where clear signed consent has not been received prior to any elective treatment appointment being booked.
27. You are at liberty to withdraw consent for further treatment at any time. You would need to write to us by post or email indicating your wish to decline further treatment and indicating that you are aware of the risks of discontinuing recommended treatment. However, LCIAD will then cease to be liable for any adverse events that may take place as a consequence of stopping the recommended treatment or maintenance plan from the day of signature. This form will be copied to your clinical record at the practice.
Payments, discounts and late payment penalties
28. The patient is responsible for the timely settlement of fees incurred after consent or implied consent to treatment even if a third party is responsible for payments. LCIAD Ltd reserves the right to charge for time, materials, and third-party expenses including laboratory work or components allocated or ordered for treatment that the patient has initially agreed to undergo either verbally or in writing but which he or she subsequently postpones or cancels altogether for the foreseeable future.
29. Invoices for professional services are sent in advance as outlined by the phases of treatment. Full payment for each phase of treatment will normally be requested and invoiced in advance of each phase. No discount is applicable for advance payment of a single or several (but not all) phases. A 7.5% advance payment discount is applicable if the full estimate (all phases) are paid in full in advance and the value of the estimate is £10,000 or greater.
30. You are responsible for settlement of any and all additional fees in full within 14 days from the day of invoice (unless otherwise agreed in writing or via an approved payment plan). Where treatment fees are to be settled by a third party, fees will be requested in advance of treatment proceeding and funds must be cleared in our account prior to appointments being scheduled. Funds from third party financing must be arranged, approved and cleared into our account prior to appointments being scheduled. If treatment is commenced and the decision is then made afterwards by the patient to obtain finance from a third party for the remainder of treatment, we reserve the right to delay scheduling of future appointments until finance has been agreed and funds cleared into our account. Any outstanding fees already incurred are payable as per these terms and conditions.
31. We reserve the right to postpone further on-going treatment if due invoices are not settled by due dates and can take no responsibility for any disruption to treatment, inconvenience or further costs that are incurred in the event this decision is made. We are sympathetic to changes in personal circumstances that may preclude further treatment or cause difficulties in making payments. In the event that settlement of fees is not possible due to a change in personal circumstances, please write to the Patient Co-ordinator Angela Thomson via normal post or e-mail firstname.lastname@example.org as soon as possible and in any event no later than 2 working weeks after the date of invoice so that we can make suitable arrangements. It is not possible to extend credit beyond that stated in the treatment planning and estimate letter unless there are exceptional circumstances and LCIAD is made aware of them as soon as possible.
32. We regret that we do not accept American Express card payments. From 1st January 2020 LCIAD Ltd will no longer accept personal cheques for payment towards treatment. However, we will accept bankers’ drafts (bankers’ cheques) which must clear at least one week prior to treatment commencing.
33. Any outstanding balance of fees not paid and cleared in full by one calendar month from the day of invoice after work is completed without arrangement will be subject to a 2.0% per calendar month interest surcharge on the following working day, compounding monthly. Please settle early if you will be unavailable after this deadline. This fee is applied monthly on the next calendar working day after the invoice date to the balance of the account until the account is settled and cleared in full. A reminder and updated statement will be sent after each calendar month to your last know e-mail or contact address by first class post if you do not have email.
34. We will send a final request to you at your last known e-mail or contact address after the second month from date of invoice with notice of impending transfer to a debt collection agency should the account remain unpaid. You should submit any valid reasons for non-payment of fees well before this date in writing by post or by email to email@example.com and request acknowledgement of receipt.
35. Account balances not settled within three calendar months from the date of invoice will be forwarded to a registered debt collection agency of our choice or HM Courts and Tribunals Service (HMCTS) Money Claim Online without further notice. A 20% surcharge is applied automatically to the account balance when the account is transferred to the collection agency or HMCTS Money Claim. We will not enter into any direct correspondence regarding fee settlement after referring the account. You should submit any further correspondence regarding this matter directly to the collection agency involved. We reserve the right to withdraw services including emergency care until due invoices are settled.
36. We will send a monthly statement to your last known e-mail address (or postal address if you do not have e-mail). Should your e-mail or home address or contact numbers change during treatment, or if you will be away from your address for an extended period, it is your responsibility to inform us by e-mail at firstname.lastname@example.org (or in writing FAO The Practice Manager, LCIAD Ltd, 28 Wimpole Street, London W1G 8GW) to prevent costs incurred by delayed payment due to lost, misdirected or late receipt of invoices. Further fees may be applied at our discretion (to a value of no greater than 10% of the final balance of the account) if extensive administrative time is spent dealing with recovery of monies owed on your account.
37. All above-mentioned fees are cumulative. The monthly 2.0% administrative fee will continue to be applied to the final balance of the account even after referral to a debt collection agency or HMCTS until the account is settled in full.
38. LCIAD Ltd has a policy of pursuing all unpaid accounts through appropriate legal channels including all time and legal costs incurred in the pursuit and recovery of due fees. Please note that this may greatly increase the total fees payable over and above the outstanding invoice amount. If you are genuinely unable to pay due to a change in circumstances, please do let us know in writing a timely fashion so that we may make mutually acceptable arrangements.
39. In the rare event that an LCIAD clinician must cancel or postpone an appointment for any reason such as illness, equipment breakdown or unavailability beyond their control, if they are running late due to an unexpectedly long treatment duration with a previous patient or more frequent visits are required for your treatment than initially predicted, LCIAD would not be liable for any loss incurred by you directly or indirectly. However, at LCIAD we do appreciate that your time and diary are at least as important as our own and undertake to minimise inconvenience as far as possible.
40. The above terms and conditions are set by LCIAD Ltd and apply to treatment carried out at or under the care of LCIAD Ltd and LCIAD Face at 28 Wimpole Street, London W1G 8GW. Default late payment penalties as set out in the Late Payment of Commercial Debts (Interest) Act 1998 F15A as amended and supplemented by the Late Payment of Commercial Debts Regulations 2002 (amended 16th March 2013) do not apply. LCIAD Ltd is authorised and regulated by the Financial Conduct Authority (Financial Services Register Licence Number 678597).