We have allowed approximately 2 hours for your initial exam. This time will be spent with Dr. Riggs at which time he will review and discuss your patient information then conduct an extensive clinical exam, a thorough medical consultation about your diagnosis and treatment plan as well as an escalation protocol. Our business manager will then go over homecare, exercises, discuss fees and office policies. We welcome all questions regarding patient care, finances and insurance.
Prognosis and treatment duration approximations will be discussed, but it is not always possible to be exact in estimating the length or outcome of treatment. TMJ disorders are complex and successful treatment is dependant on body response, patient compliance, primary diagnosis, stress, anxiety, environment, lifestyle and many other contributing factors.
Before leaving the office subsequent appointments will be scheduled to begin treatment. We look forward to providing optimal, conservative, informative and comprehensive care.
What to bring to your Appointment
The following items are necessary for Dr. Riggs to evaluate and consult with you at your initial examination.This will help to expedite treatment.
- Patient Questionnaire: We have included downloadable forms on this website you can print and fill out for your convenience. Please take your time and remember each and every question is important and should be considered carefully. This information is a vital part of your clinical exam and without it being completed prior to your first appointment it will be necessary to reschedule. We have allowed approximately 2 hours for the exam and consultation however we have not allowed time to fill out forms in the office. If you have questions regarding the forms please do not hesitate to contact our office staff for assistance.
- " X-rays and/or Scans: Please include current and past panoramic x-rays, periapical and bitewing dental films, MRI or CT scans, CDs of the scans, and all radiology reports. There are times, depending on your diagnosis; we may need one or the other to help you receive reimbursement.
- Insurance Cards: Please bring both medical and dental insurance cards. There are times, depending on your diagnosis; we may need one or the other.
- Family member or friend: It is not necessary to bring someone if you are over the age of 18 years; however it is a good idea. We give a great deal of information and it can be useful for someone else to listen with you. If you are under 18 years old we do require a parent or guardian to be present for Dr. Riggs to treat you.
- Night Guards/Splints/Retainers: Please bring any type of mouth piece that you currently wear or have worn in the past whether it is for daytime or nighttime. Please bring orthodontic retainers, partials and denture, splints and night guards. This will allow Dr. Riggs to evaluate current appliances and make recommendations. Dr. Riggs makes every effort to use existing appliances, when possible, in an effort to be cost effective.
To differentiate the complex signs and symptoms of orofacial pain disorders it is necessary to allow adequate time at the initial appointment. Approximately 2 hours have been reserved for your first appointment with Dr. Riggs. Please allow time in your day so you are not rushed. To perform a comprehensive history, examination, consultation, treatment and financial plan the following evaluations may include but are not limited to the following.
The Initial Interview:
A comprehensive history of the chief complaint is explored with respect to location, duration, intensity, timing, quality, frequency and contributing factors which aggravate, precipitate or perpetuate symptoms
- Sleep Evaluation
- Review of Systems
- Medications Evaluation
- Review of Medical and Dental History
- Review Previous Treatments
- Stress/Depression Screening
- Muscle Function, Strength and Tone
- Upper Quarter and Facial Muscle Palpation
- Cranial Nerve Evaluation
- Otoscopic Evaluation
- Joint Mobility Evaluation
- Active and Passive Range of Motion for the Neck, Jaw and Shoulders
- Muscle and Joint Provocation Tests including Stretch Response, Contraction Response, Distraction, Loading, Medial and Lateral Compression Tests
- Differential of Joint Sounds
- Postural Evaluation
- Parafunctional Evaluation
- Dental Evaluation (screening for abnormalities and contributing factors) of Soft and Hard Tissue
- Occlusal Assessment
- Pain Profile (if symptoms have existed for 6 months or more)
- Imaging (hard and /or soft tissue)
- EMG Evaluation (if appropriate)
- Diagnostic Anesthetic Blocks (if necessary)
- Normal Anatomy and Current Findings
- Behavior Modification and Homecare
- Stretching and Exercise Program
- Treatment Recommendations, Options
- Referrals Necessary for Medical, Dental, Physical and/or Psychological Evaluations
- Target Dates with Escalation Protocol
- Letters of evaluation to Treating and Referring Doctors
- Consultation with doctors Providing Active Treatment
- Financial Consultation and Planning
- Advantages and Disadvantages of Treatment Options or No Treatment
Given the current economy, we are acutely aware of the need for most people to utilize their insurance as a mode of payment; however we are unable to accept insurance on assignment at this time. The decision for Dr. Riggs to practice independently of the managed healthcare networks is due to the fact that TM disorders are very complex and coverage varies from company to company and from policy to policy, therefore there is no consistency in coverage. Even though payment is due at the time treatment is rendered, we attempt to keep treatment affordable by offering financial arrangements and accepting all major credit cards as well as CareCredit. We openly invite you to discuss all payment options with our staff prior to your initial appointment. Once we have a working diagnosis we can discuss your insurance in greater detail. In a further attempt to help you receive reimbursement, we will provide a completed insurance form that you can send to your insurance company. We make every effort to respond to any additional requests the insurance company may have but we can not guarantee reimbursement. In the event that your policy does not cover your treatment cost, it is important for you to remember you are responsible for all fees incurred.
We are happy to offer treatment to Medicare patients; however we are a non-participating provider for Medicare. This means that we are not able to accept Medicare for payment. We do charge Medicare fees for allowed services and follow their guidelines for filing claims for each patient. There are still many procedures that Medicare does not cover that may be a part of your treatment plan and these fees will be charged at regular office prices. You will be responsible for all fees incurred at the time of the visit and we will make every effort to help you get reimbursement to the extent Medicare allows.
Appointments and Cancellations
Dr. Riggs provides the highest quality of care to each patient. We do not double book and we attempt to allow adequate time to evaluate and treat each patient as an individual. In the event you need to cancel or reschedule your appointment, we ask for your consideration of others in pain by giving us a 24 business hour notice. This will allow us to accommodate others who are awaiting appointments. We will be enforcing this policy with a no show charge equal to the office visit scheduled that will be payable on or before the next visit.
Dr. Riggs and staff look forward to providing you with excellent care and treatment.