Welcome to your Family Dental Care Inc., Dental Plan We are so happy to have the opportunity to serve your dental needs. You can view and download our Welcome Letter below to start learning more about our dental network.

Member Handbook

Download your copy of our Member Handbook for detailed information on how you can get the most out of your dental care. *Our member handbook is also available in other formats. To request a member handbook in large print, a different language, or in another format at no cost to you, call Customer Service at 503-644-2663, or Toll Free at 1-888-350-0996/TTY 711  or email us at quality@familydentalcareinc.com

Clinic Locations

To make an appointment see our

clinic directory.

Member Handbook Click here for more information

Download a copy of our Member Handbook for detailed information on how you can get the most out of your dental care.

*Our member handbook is also available in other formats. To request a member handbook in large print, a different language, or in another format at no cost to you, call Customer Service at 503-644-2663, or Toll Free at 1-888-350-0996/TTY 711  or quality@familydentalcareinc.com.

Member Rights Click here for more information
As an FDCi Member, You Have the Right To…
  • To be treated with dignity, respect and a consideration for privacy;
  • To not be discriminated against;
  • To be treated by participating providers the same as other people seeking dental services;
  • To choose a Primary Care Dentist (PCD) and change to another PCD in accordance with OAR 410-141-0080;
  • To obtain a second opinion at no-cost to the Member. A second opinion will be from a state licensed and qualified dental professional. It is preferable that a Member seek an FDCi Dental Provider from the FDCi Dental Provider Network. However, if this is not an option for the Member, they may seek an out-of-network dental provider at no-cost, following approval from the FDCi Dental Director;
  • To have a friend, family member, or advocate with you during appointments and other times as needed within clinical guidelines;
  • To be actively involved in the development of your treatment plan;
  • To be given information about covered and non-covered services to make an informed decision about proposed treatment;
  • To consent to treatment or refuse dental services, and to be advised of the consequences of that decision, except for court ordered services;
  • To receive written materials describing rights, responsibilities, covered benefits, accessing services and what to do in an emergency;
  • To have the information explained in a manner that is understandable;
  • To receive necessary and reasonable services to diagnose your condition;
  • To receive covered services under the Oregon Health Plan (OHP) that meet generally accepted standards of practice and are dentally appropriate;
  • To obtain covered preventative services;
  • To have access to urgent and emergency services 24 hours a day, 7 days a week;
  • To ask if FDCi has special financial arrangements with FDCi Providers which can affect the services you may need. Call FDCi to request this information;
  • To receive a referral of specialty providers for dentally appropriate, covered services;
  • To have a clinical record maintained which documents conditions, services received, and referrals made;
  • To have access to your own clinical record, unless your doctor thinks it’s bad for you;
  • To send a copy of your record to another provider;
  • To make a statement of wishes for treatment and obtain a power of attorney for dental care;
  • To receive written notice before a service is denied, stopped or reduced;
  • To be informed on how to make a complaint or appeal and receive a response from FDCi;
  • To request an Administrative Hearing with the Department of Health and Human Services (DHS);
  • To receive notice from your provider of an appointment cancellation in a timely manner;
  • To receive interpreter services;
  • To receive information on the structure and operation of our organization and whether our providers are paid to limit services. FDCi does not have any incentive plans with any providers;
  • To be free from any form of restraint or seclusion used to force, discipline, or punish you, or to make your treatment easier, as specified in Federal regulations on the use of restraints and seclusion;
  • To have written materials explained in a manner that is understandable to the member.
  • FDCi prohibits clinics or providers from encouraging a member to withdraw a Grievance which is already filed.
  • FDCi prohibits punitive action against a Provider for supporting a member’s Grievance.

Family Dental Care, Inc. must follow state and federal civil rights laws. We cannot treat people unfairly in any of our programs or activities because of a person’s: age, color, disability, gender identity, genetic information, marital status, national origin, pregnancy, race, religion, sex, sexual orientation, veteran, or whistle-blower status. If you feel you were treated unfairly for any of these reasons in addition to filing a complaint with Family Dental Care, Inc. you may contact Oregon Health Authority’s civil rights manager.  You can do so in one of these ways:

Web: www.oregon.gov/OHA/OEI

Email: OHA.PublicCivilRights@dhsoha.state.or.us

Phone: 844-882-7889, TTY 711

Mail: OHA Office of Equity and Inclusion 421 SW Oak St., Suite 750 Portland, OR 97204

Family Dental Care, Inc. and our providers believes it is important that the dental care we provide value and respect the diversity of our members.  We will strive to deliver care that is both culturally and linguistically responsive to the needs of our members.

File a Complaint, Appeal or Grievance Click here for more information
FDCi Member Complaints

An FDCi Member has the right to file a complaint in writing or by telephone. A completed complaint form may be:

Mailed to:
Family Dental Care, Inc.
ATTN: Appeals & Grievances
6700 SW 105th Avenue Suite 210
Beaverton, Oregon 97008

To submit a complaint by phone call FDCi Customer Service at 503.644.2663 TTY 711 or 1.888.350.0996. Download the OHP Complaint Form in your preferred language.

OHP Complaint Form – English

OHP Complaint Form – Spanish

OHP Complaint Form – Vietnamese

OHP Complaint Form – Russian

FDCi Member Appeal Requests

An FDCi Member has the right to file an appeal request within 60 days of the effective date of a Notice of Action. Completed appeal forms and/or administrative hearing requests may be:

Mailed to:
Family Dental Clinic, Inc.
ATTN: Appeals & Grievances
6700 SW 105th Avenue Suite 210
Beaverton, Oregon 97008

To submit an appeal request by phone you can call FDCi Customer Service at 503.644.2663 TTY 711 or 1.888.350.0996. Download the OHP Denial of Medical Services Appeal and Hearing Request Form below in your preferred language.

OHP Appeal & Hearing Request Form – English

OHP Appeal & Hearing Request Form – Spanish

OHP Appeal & Hearing Request Form – Vietnamese

OHP Appeal & Hearing Request Form – Russian

FDCi Member Administrative Hearing Requests

If an FDCi Member does not agree with the results of an appeal request they can request an administrative hearing. An administrative hearing cannot be requested until an appeal has been completed.

An FDCi Member has the right to file an administrative hearing request within 120 days of the effective date of a Notice of Appeal Resolution. Completed administrative hearing requests may be:

Mailed to:
Family Dental Clinic, Inc.
ATTN: Appeals & Grievances
6700 SW 105th Avenue Suite 210
Beaverton, Oregon 97008

To submit an administrative hearing request by phone you can call FDCi Customer Service at 503.644.2663 TTY 711 or 1.888.350.0996. Download the OHP Denial of Medical Services Appeal and Hearing Request Form below.

Download Form

Fraud, Waste & Abuse Click here for more information
Suspected Fraud, Waste and Abuse

FDCi is funded by the state and federal governments. We take cases of Fraud, Waste and Abuse seriously.

Question: Who can report Fraud, Waste and Abuse? Answer: Anyone, including:

  • Patients
  • Providers
  • Staff

How to report Fraud, Waste and Abuse:

  • Call the FDCi Compliance Department toll free at 1-888-350-0996, or local at 503-644-2663 option 4

Clinical Practice Protocols Click here for more information
The following clinical practice guidelines have been reviewed and approved for implementation by the Quality Improvement Committee:

1. Guidelines from the American Heart Association, Prevention of Infective Endocarditis, https://www.ahajournals.org/doi/full/10.1161/circulationaha.106.183095

2. Prevention of Orthopedic Implant Infection in Patients Undergoing Dental Procedures: Evidence-Based Guideline and Evidence Report, https://www.ncbi.nlm.nih.gov/pubmed/23457068

3. Dental Treatment of Patients with Joints Replacement: A Position Paper from the American Academy of Oral Medicine, https://jada.ada.org/article/S0002-8177(14)64743-7/fulltext

4. Dental Radiographic Examinations: ‘Recommendations for Patient Selection and limiting Radiation Exposure’, American Dental Association & Food and Drug Administration, https://www.ada.org/~/media/ADA/Member%20Center/FIles/Dental_Radiographic_Examinations_2012.ashx

5. Oral Health During Pregnancy: ‘A National Consensus Statement’, National Maternal and Child Oral Health Resource Center, https://www.mchoralhealth.org/materials/consensus_statement.php

6. American Dental Association, Center for Evidence-Based Dentistry, ‘Clinical Practice Guidelines’, https://ebd.ada.org/en/evidence/guidelines

7. Academy of Pediatric Dentistry, ‘Oral Health Policies & Recommendations’ (Reference Manual), https://www.aapd.org/research/oral-health-policies–recommendations/

8. Centers for Disease Control and Prevention, Tobacco Cessation, Best Practices, https://www.cdc.gov/tobacco/quit_smoking/cessation/index.htm

9. Oregon Health Authority, October 2018, ‘Oregon Acute Opiate Prescribing Guidelines’, https://www.oregon.gov/oha/PH/PREVENTIONWELLNESS/SUBSTANCEUSE/OPIOIDS/Documents/Acute-Prescribing-Guidelines.pdf https://www.oregon.gov/oha/PH/PREVENTIONWELLNESS/SUBSTANCEUSE/OPIOIDS/Documents/oregon-recommended-opioid-guidelines-dentists.pdf

Notice of Non-Discrimination Click here for more information
Family Dental Care, Inc. must follow state and federal civil rights laws. We cannot treat people unfairly in any of our programs or activities because of a person’s: age, color, disability, gender identity, genetic information, marital status, national origin, pregnancy, race, religion, sex, sexual orientation, veteran, or whistle-blower status.

Family Dental Care, Inc. provides free aids and services to people with disabilities to communicate effectively with us, such as:

• Qualified sign language interpreters
• Written information in other formats (large print, audio, accessible electronic formats, other formats)
• Provides free language services to people whose primary language is not English, such as: qualified interpreters and information written in other languages.

If you need these services, please contact FDCi Customer Service at 503.644.2663 TTY 711.

If you believe that Family Dental Care, Inc. has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:

(A) Quality Improvement Department
Family Dental Care, Inc.
6700 SW 105th Avenue Suite 210
Beaverton, Oregon 97008
(P) 503.644.2663 TTY 711

You can file a grievance in person or by mail, fax, or our secure web form. FDCi does not accept any personal member information received through unsecure or unencrypted service. If you need help filing a grievance, an FDCi Care Coordinator is available to help you.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf or by mail or phone at:

U.S. Department of Health and Human Services
200 Independence Avenue,
Room 509F, HHH Building,
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)

Complaint forms are available at: http://www.hhs.gov/ocr/office/file/index.html

English

ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call (503-644-2663) TTY (711).

Family Dental Care, Inc. (FDCi) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

Español (Spanish)

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al Call (503-644-2663) TTY (711).

Family Dental Care, Inc. (FDCi) cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo.

Russian

ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните Call (503-644-2663) TTY (711).

Family Dental Care, Inc. (FDCi) соблюдает применимое федеральное законодательство в области гражданских прав и не допускает дискриминации по признакам расы, цвета кожи, национальной

принадлежности, возраста, инвалидности или пола.

Vietnamese

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số Call (503-644-2663) TTY (711).

Family Dental Care, Inc. (FDCi) tuân thủ luật dân quyền hiện hành của Liên bang và không phân biệt đối xử dựa rên chủng tộc, màu da, nguồn gốc quốc gia, độ tuổi, khuyết tật, hoặc giới tính.

Notice of Privacy Practices Click here for more information

NOTICE OF PRIVACY PRACTICES

This notice describes how medical information about you may be used and disclosed. This notice explains how you can get access to this information. Please review it carefully.

PROTECTED HEALTH INFORMATION (PHI)

What is PHI? Protected Health Information, or PHI, is any information that is specific to you and your health, such as:

  • Your Medical History
  • Your Medications
  • Your Test Results
  • Your Social Security Number
  • Your Address or Phone Number
  • Your Date of Birth

Here at Family Dental Care, Inc. we have systems to keep your PHI safe. Our employees get training every year on what needs to be protected, and how.

SHARING YOUR PHI

There are times when we can use and share your PHI. Some examples are:

  • Managing your treatment needs
  • To help your providers
  • Research for our members’ benefit
  • Responding to lawsuits
  • Responding to government requests
  • To help with public safety issues
  • To obey the law


YOUR RIGHTS WITH PHI

You have rights to your PHI. The government says we must give you the chance to:

  • Get a copy of this notice
  • Get a copy of your PHI
  • Get a list of people who have seen your PHI
  • Correct your PHI if it’s wrong
  • Ask us to limit who can see your PHI
  • File a complaint if you think your rights have been violated
  • Choose some to act for you

If you have any questions about this notice, please call Customer Service at the number above.

Read on for more information.

SHARING YOU PHI

We may use or share PHI to do business activities. These activities include things like:

For TreatmentReferrals and Prior-Authorizations.
Case Management or Care Coordination.
Programs for early detection of disease.
Health Care OperationsTo give you more information about new treatments or benefit options.
To help perform business with other companies, like paying your provider.
To help public health authorities to prevent public health and safety issues.
With law enforcement when required by law.
With research companies when approved by the appropriate governing bodies.

We will protect your PHI and make sure that all sharing of this information follows the rules above. If we use or share your information for any other reason not allowable by law, we will get your written permission.

YOU HAVE THE RIGHT TO

Get a copy of your PHI.You must ask for this in writing. Send a letter to the address above. You will get a response within 30 days.
Correct your PHI if it is wrong.You must ask for this in writing. We cannot change some of your information. If we cannot make the changes you asked for, we will let you know.
Get a list of people who have seen your PHI.You must ask for this in writing. It may not include some who have seen your PHI for purposes like providers or law enforcement.
Restrict or limit us from using your PHI.You must ask for this in writing. If there are certain people or companies, you do not want us to share your PHI with please tell us.
Share your PHI with someone.You must ask for this in writing. If you would like someone you know to help you with your health management please tell us. We just need to know who it is, and for how long you want them to have access. Remember that once we get permission to share information, we cannot be certain that the person who gets the information from us will not share it with someone else.
Choose your method of communication.If you would like us to send you information in a certain way, please tell us. This could be anything from using the right phone number or email, to asking us not to send any letters through the US mail. Only if required by law, we may not be able to agree with your request.
Get a copy of this notice.At any time, you can ask us for a copy of this notice. This can be done by phone, email or US mail.

FILING A COMPLAINT

If you think your privacy has been shared when it should not have been, you may send a written complaint to our Appeals & Grievances Department. We will not react against you for your complaint.

Please send your complaint to:
    Family Dental Care, Inc.
    Attn: Appeals and Grievances Department
    6700 SW 105th Ave., Suite 210
    Beaverton, OR 97008

You may also send your complaints to the US Department of Health and Human Services:
    U.S. Department of Health and Human Services
    200 Independence Ave. SW
    Room 509F, HHH Building
    Washington DC 20201

CHANGES TO THIS NOTICE

We can change the terms of this notice, and the changes will apply to all information we have about you. Updated notices will be available in our office and on our web site: familydentalcareinc.com.

For more information on this notice of privacy practices:

Contact the Family Dental Care, Inc. (FDCi) Compliance Officer at 503-644-2663 or toll-free at 888-350-0996, TTY 711, if you have any questions about this notice or if you want more information on privacy.

Privacy rules are overseen by the Compliance Officer, who also acts as the Privacy Officer.

This notice is effective January 2, 2020.

Cancellations, Missed Appointments & No Shows Click here for more information

FDCi takes cancellations, missed appointments and no shows seriously. These are missed opportunities for dental care, and actions may be taken when a member misses 2 or more appointments. Remember to notify your dentist more than 24 hours before your appointment if you will not be able to make it. This allows dentists the time to cancel your appointment reasonably and perhaps offer the time to someone else. Sometimes things come up and we understand. The important thing is to communicate with your dental office if you can’t make it in.

Sometimes our dentists have something come up like an emergency appointment. Our clinics will also do their best in notifying members as soon as possible if there is going to be a wait for them to be seen. If the wait is longer than 45 minutes, the clinic staff will offer the member the opportunity to reschedule.

**If a Member has two or more late canceled or missed appointments this may lead to more serious actions being taken by the provider such as dismissing the patient. When a Member has missed two appointments or been dismissed for this reason FDCi will advise the Member through a letter of the seriousness of missing or late-cancelling multiple appointments and indicate that further late-cancelled or missed appointment may result in FDCi contacting the state to determine actions that may be taken.  A member who has been dismissed will be assisted by FDCi in finding a new Primary Care Dentist (PCD).

How do I know if I need URGENT Dental Care or EMERGENCY care?

Please read below if you are unsure of what to do when experiencing dental pain.

Urgent care can be handled within 1 to 2 weeks depending on the member’s condition by your FDCi Provider.

Urgent dental care requires prompt but not immediate treatment.

Examples of Urgent Conditions:

  • A toothache
  • Swollen or bleeding gums
  • Crowns that have fallen off or broken
  • Pain that is bad enough to keep you from sleeping or eating and does not stop when you take over the counter medicine such as Aspirin or Tylenol

Before going to an urgent care facility for dental pain you should: contact your primary dentist office, they will evaluate your condition and make an appointment appropriate for your needs.

(Without approval from your dental plan you may be responsible for the cost of your bill.)

Emergency care is covered 24 hours a day, 7 days a week, by your FDCi Provider.

A dental emergency is dental care requiring immediate treatment.

Examples of Dental Emergencies:

  • A tooth that has been knocked out
  • Fracture to the jaw/facial bones
  • Heavy Bleeding that does not stop
  • Infection that makes it hard to breathe or swallow

Before going to an emergency facility for dental pain you should contact your primary care dentist, or their after-hours phone line.

(Without approval from your Dental Plan you may be responsible for the cost of your bill.)