All-on-X Co-Treatment

All-on-X co-treatment referral.

We perform the surgery, the conversion and the provisionals. You deliver the definitive prosthesis in your own operatory and bill it at your own fee. Complete this form and attach any radiographs — we contact the patient within one business day.

1 Referring practice
2 Patient
3 The case

Send a pano or CBCT if you have one — but do not hold the referral waiting for it.

Arch
Current status
Radiographs sent

Attach a pano, FMX, CBCT export or clinical photographs — JPG, PNG, PDF, DICOM or a zip, up to 9 MB in total. Larger studies: send the referral now and email reception@anewyougj.com or drop a link to your imaging portal in the notes below. Do not hold the referral waiting for images.

4 Medical history

For medical insurance billing, surgical planning and sedation.

Certain medically complex patients qualify for medical rather than dental billing, preserving the dental benefit for your restorative work. Not every patient with these diagnoses qualifies — coverage depends on the payer, plan and documented medical necessity.
5 Your restorative fee

Required — we present it to the patient under your name at the surgical consult.

$ per arch

Our laboratory invoices your office directly for the definitive prosthesis. The current lab schedule and our surgical fees are in the co-treatment packet — ask us for a copy or call the office.

You set this number — it is your restorative case. The packet carries our suggested range and the floor we ask you not to go below. Please hold the fee for twelve months from this referral.

We quote one total to the patient at the surgical consult: our surgical fee, and your fee as its own line under your name. An itemised surgical plan follows to your office after the visit. Cases needing sinus augmentation, grafting or ridge augmentation are quoted higher.

6 How you want this case run Definitive delivery
Annual prosthetic maintenance
Before you plan
If we deliver the definitive prosthesis, we bill the patient for it directly and your office does not receive a restorative fee for this case. The patient still returns to you for recall.
7 Sign and send

Typing your name here has the same effect as signing the paper form.

Sent securely to reception@anewyougj.com. We contact the patient within one business day and confirm receipt with your office.
Urgent? Call (970) 763-1522. After hours, text Dr. Yant on (301) 616-7734.

Referral received.

It's with our front desk. We'll contact your patient within one business day and confirm back to your office. If this is urgent, call (970) 763-1522 as well.

1

We contact the patient within one business day and book the surgical consult.

2

CBCT and records taken here; you receive the itemised plan with both fees.

3

Surgery, conversion, healing and the PMMA try-in, all at our office.

4

Patient returns to you for shade, then for delivery of the final.

Call Text Request Appt