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Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost.
Under the law, health care providers need to give patients who don’t have certain types of health care coverage or who are not using certain types of health care coverage an estimate of their bill for health care items and services before those items or services are provided.
- You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling such items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
- If you schedule a health care item or service at least 3 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 1 business day after scheduling. If you schedule a health care item or service at least 10 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after scheduling. You can also ask any health care provider or facility for a Good Faith Estimate before you schedule an item or service. If you do, make sure the healthcare provider or facility gives you a Good Faith Estimate in writing within 3-business days after you ask.
- If you receive a bill that is at least $400 more for any provider or facility than your Good Faith Estimate from that provider or facility, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate and the bill.
PRIVACY ACT STATEMENT: CMS is authorized to collect the information on this form and any supporting documentation under section 2799B-7 of the Public Health Service Act, as added by section 112 of the No Surprises Act, title I of Division BB of the Consolidated Appropriations Act, 2021 (Pub. L. 116-260). We need the information on the form to process your request to initiate a payment dispute, verify the eligibility of your dispute for the PPDR process, and to determine whether any conflict of interest exists with the independent dispute resolution entity selected to decide your dispute. The information may also be used to: (1) support a decision on your dispute; (2) support the ongoing operation and oversight of the PPDR program; (3) evaluate selected IDR entity’s compliance with program rules. Providing the requested information is voluntary. But failing to provide it may delay or prevent processing of your dispute, or it could cause your dispute to be decided in favor of the provider or facility.
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Our patients leave smiling
Doctor Ruffner is amazing! He really cares about his patients and about the work he does. He knows I have terrible anxiety but he still wipes the tears away when I’m having a hard time. I can’t thank him enough for all he’s done for me and my family. I really appreciate his dental hygentists too, his son is following in his footsteps. The young lady (can’t think of her name…
My family loves Maple Shade Dental! Dr Shanahan is an Amazing dentist!!
The staff is very friendly, patient , and I wouldn’t change my dentist for anything! I look forward to getting my teeth cleaned !
Dr. Shanahan’ work is top notch and his manner is very kind and considerate. I think Stephanie was the dental assistant’s name and she was fantastic. She kept me apprised of what was happening and why, she was skilled, gentle, and stayed focused. The staff help create an atmosphere in the office that is very pleasant.
What a GREAT dental office!! The staff & doctors are wonderful & caring professionals. Every time I go there it feels like visiting family. If you are looking for a dental office that cares about you & your dental needs …. THIS is the OFFICE!!!
Friendly people, great service provided and I always leave with a smile!
I’ve always been greeted by a friendly face and the whole staff is not only professional, but very friendly too!
Both the hygienist and the dentist was very polite and thorough. Both asked if I had any concerns or problems with my teeth. I would recommend anyone to go to this group.
Quick appointment and flexibility with being a bit late due to train and traffic. Doctor Ruffner has a good chair side manner.
The office staff has been very friendly. The appointments do not take long and I am able to take a lunch break and come to the dentist. This is important to me.
Every person in the office is so friendly and accommodating, and my dental health has improved drastically since I started going to Maple Shade.
I love the people. They make you feel at home. They work with you. Understanding, helpful. They go out of their way for you as a patient. Amazing service.
The staff, including Dr. Shanahan, were wonderful to work with. They always greet me with a warm smile and are willing to go that extra mile to make sure my experience is a positive one.
Very kind and very professional service. Just recently had my first visit and they were kind enough to give me a coupon that dropped my x-ray/inspection down to only $29.99. As someone that currently doesn’t have dental insurance this was a huge relief! Huge thank you to the staff at Maple Shade Dental of East Peoria
Good professional cleaning without any pain. Hygienist consistently checked to make sure everything was OK.
Quick, effective appointments. Good prices and payment options. Great staff. Awesome service and results.
I have always received great care
We always receive friendly professional and efficient service!
Did a very good job on my teeth no pain at all
A very nice and professional staff.
Jennifer and Julie are just wonderful. So professional and friendly.
My dental hygentist was beyond excellent. Wendy is super professional and a wonderful representative of maple shade dental
Dr. Ruffner was recommended to me by my son. As a new patient, the office was able to give me an appointment within a month’s time, and sent two reminders via phone and through text in order that I did not forget my appointment. From the point of walking into their facility, I was greeted very kindly by Tonya, assisted by Richard who guided me through all x-rays and procedures, treated by Ka…
A very good experience. The care given was top notch by the professional and friendly staff at Illini drive. Yes, I would recommend them!
People are so kind.
Had minor surgery with almost no pain or bleeding. Doc and assistant were both very nice and comforting!
Wendy was absolutely wonderful. 5 star!!! Whatever you are paying her is not enough.
Wonderful, upbeat, professional dentist, hygenist and staff. Also ease of making appointment and being able to find close parking. Clean, modern decor throughout office.
Very friendly. Very informative
Wendy was a great dental hygienist, and the overall staff is really nice!
I always receive wonderful care at Maple Shade Dental Group. Karen is a fantastic hygienist and Drs. Shanahan and Ruffner are both excellent dentists.
Made me feel at ease, friendly & it didn’t hurt
Very friendly, kind, and professional
Everyone is friendly and cares about my dental health. True professionals.
Everyone is polite and does a good job
Very caring about any concerns that you have, and very knowledgeable
I came because my husband goes to Maple Shade and everyone is always pleasant and professional.
I absolutely LOVE Maple Shade! They are very professional, affordable, and friendly!! We see both the dentist and the ortho team! Dr. Whittet and his team is awesome!
very friendly and professional staff
Maple Shade is a very warm and caring group of professionals.
Everyone was very friendly
Quality staff and services
Very friendly and professional staff. Karen is the best!!
I’ve been a patient at Maple Shade for 27 years. That should tell you all you need to know about the type of dental practice it is. Everyone there is tops.
My hygienist, Jen, is why I continue to come back. She knows me and my family and all about the type of care my teeth need. She makes it feel like going to see a friend rather than a random dental cleaning. Also love the receptionist. She greets me with my first name and I feel very welcome coming in the door. Great staff.
Really kind people, calm appealing environment, quick visits. Would recommend.
Everyone at Maple Shade is great. Always friendly and helpful and they really care about you.
Your staff and hygienist were great!!!
Dr. Rufner is EXCELLENT!! Indeed, all of the staff that i encountered were so friendly and helpful.
Friendly and no pain
Great service and awesome staff!! I’ve changed my dentist I’ve had for 30 yrs to Maple Shades Dentistry! !
On time, informed me what was being done and cared about my apporintment.
Staff seemed to work hard to make my visit as pleasant as possible.
Great customer service
Dr Shanahan is an extremely caring and gentle dentist. The staff at that office is top notch.
We always have a great experience at Maple Shade. My kids love going to the dentist!
Dr. Susan was awesome! Very friendly a great manners.
Excellent care and concern.
I am very happy with all aspects of my visits there…..from the first person I speak to when I arrive to the last one I am in contact with when I leave….except for the fact that I have to pay this person – ;) Between those times, I also feel that Dr. Shanahan “knows his stuff” and is in complete control with whatever work I need done on my teeth! Oh…I also really…
What a great group of people that take their time. My entire family goes to Maple Shade and we all really like them.
Everyone is the office was very helpful and friendly. Choice of treatment was given when possible.
My appointment was right on time. My hygienist, Karen, is friendly, efficient and knowledgeable
Solid place with great customer service. Fun staff and great Doctors.
Everyone was great and very friendly. They were also very gentle and really cares.
Wonderful set of people that work there. Very friendly and out going.
Good service, friendly staff, better results with my mouth-health than many previous dentists over the years.
Great friendly staff! This appt was for my children (ages 9 and 6). They were nervous, but everyone in the office put them at ease right away!
Dr Ruffner is a great dentist who cares about his patients
The people!!! Dr. Susan, Julie, Jamie and Jen rock!
I always feel like I am treated with respect and kindness. I receive wonderful care by the hygienist and Dentist. The office staff is friendly and very helpful. I look forward to my twice a year visits!
My technician/hygienist is the best ever. Very professional, pleasant, and really a neat lady. Dr. Shanahan is a good guy too.
Dr Willey is fantastic
Everyone is really great and helpful. Plus all is very nice.
Dental hygienist was one of the best that has ever cleaned my teeth.
My hygenist is fantastic – not only the face of Maple Shade, but the hands and the heart of Maple Shade as well.
Everyone I came in contact with during my visit was very kind, and they appeared to be happy with their jobs there. They were efficient, and seemed to be experienced in what they were doing.
Great people to work with
Friendly staff w/ hardly any delays
Everyone is always so nice and helpful
Wendy is a very good dental hygienist
Everyone was so friendly and never made me feel like I was an annoyance. (Even though I very well could have been)
On time appointment, quick visit, friendly staff,
Everyone was friendly and helpful and the dentist was wonderful
We are very happy with the friendly staff & having the specialist Dentist so we do not have to go to another office! We tell our friends all the time where we go!
Pleasant Place, concern providers, welcoming
The hygienist explained things and had such patience with my son who has Severe ADHD. The Dentist was very nice also. Service with a smile and didn’t feel rushed.
Dr. Willy is awesome! My 12 year old broke the bottom half of his front teeth a couple years ago on his scooter and we had them fixed. They never looked completely natural or even. Dr. Willy took off the old (I believe a resin surface filling?) and redid them. They look amazing and you can’t tell they aren’t his real front teeth! The inside back of the teeth had always bothered my son…
I know the staff and they are super nice! They make you feel at ease. WE LOVE Dr Ruffner!
People and the skill of delivered treatment. I depend on Dr Ruffner for a solid plan and perfect blend of skill and personality.
Jennifer! and reception staff! Always a great and warm experience. Services are done in a timely and professional manner, office is clean and well-maintained.
I like my dental hygienist! She has been my dental hygienist for 10 yrs and is an amazing person and does a great job. Thanks Karen! You deserve the best employee award :-)
Jen helped our daughter relax and have a fun time while getting her cleaning. She even praised her for taking better care of her teeth this time. I believe this helps my daughter’s confidence.
everyone in the office is awesome! they treat you like family and explain all procedures completely before starting. they are flexible in the scheduling.
Dr. Ruffner is amazing! It was our son’s first cavity and Dr. Ruffner was patient and explained everything to our son as he went. Great experience from an outstanding doctor.
I took my elderly mother to Maple Shade EP for her 1st visit this past week. Dr Shanahan tightened the wires that hold her partial in place, gave his recommendations, and had her fixed up in no time. She is very pleased with the results. My husband and I have been going to Dr. S. I think since the practice opened on Illini Drive. We’ve always been perfectly satisfied. Thank you!
Friendly and awesome staff. I am always satisfied with my treatment/cleaning. Highly recommended dental office!
The receptionist was awesome and very accommodating to find me an earlier appointment. The dentist and staff were friendly and informative.
Dr. Ruffner and his assistant are both great,
Always have a good experience
Great service from the staff, dental assistant and dentist!!!
Every person who works there is friendly and goes out of their way to make you feel comfortable, especially Dr Shanahan.
I really love the staff and I was in and out quickly. The dentists themselves are friendly and informative.
Theo is 3. This was his first dental exam. He was not scared. Karen showed him her tools and practiced on his fingers to make sure he had an idea of what was to come. She seemed to put him at ease. (Cartoons helped too.)
Dr. Ruffner and his assistant today were very understanding and made the visit and repair work as pleasant as could be. I got in right away the same day I called.
I had my teeth cleaned there the staff or very polite and then their job very accurately. That’s what keep me going back
High Quality Care of patient and work completed.
Jessica was great with my 11 year old; she was patient and kind! Great job!
Everyone from the receptionist to the dentist were very attentive and welcoming.
I was delightfully impressed with every flow of Maple Shade. Honestly i am Extremely critical of dentists and anything pertaining. I was highly impressed.
Very nice and willing to get you in as soon as they can. The whole staff is just super friendly.
good, professional service
Friendly and very helpful staff! Karen is fantastic!
Very friendly staff!
Friendly staff and great service!
Always good service.
Everyone is so nice, helpful, and professional
Good service, right in and out with minimal wait
Service prices are reasonable, personnel is accommodating and I am satisfied thus far with the work I’ve had done.
The Staff at Maple Shade provide excellent customer service. They make the dental experience truly feel like you’received at a picnic with friends and family.
I would have never thought I would change my dentist but after my daughter had braces at Maple Shade the staff impressed me. I have had nothing but pleasant experiences with Maple Shade. Am now a patient myself.
Everyone is so friendly!!!
Love the overall experience and staff…always feel comfortable when I’m there
Very friendly staff, very quick and efficient check in and out. But most of all I really felt comfortable with Dr. Ruffen and he did amazing work on me. Super impressed with the whole office start to finish.
Excellent. Dr Ruffner is very experienced and thoughtful.
Good place, friendly people.
The hygienist is awesome!!!
Very warm & attentive staff. I felt cared for. My hygienist talked me throughout the entire treatment. Way to go Jen. Thank you
Great hygienist. She is awesome. Makes it convenient for my schedule.
The office is well organized, the staff are highly competent and the wait time is always minimal. The office sends email reminder of appointment as well as phone calls to confirm one is able to keep the appointment.
Friendly. No wait – well organized office. Excellent care. Trustworthy.
I tell everyone how wonderful you are, how Dr. Ruffner is. I have referred SEVERAL people to your group and they love you as much as I do!
Everyone is very pleasant, and caring.
Great patient care from the time I stepped off the elevator to the time I left
Minimal wait times and friendly staff.
Everyone i came into contact with was extremely nice and courteous.
Always excellent service from the entire staff!
Excellent, friendly service! Ready when I arrived, appointment easily completed on time, dentist was ready quickly too!
Jenn and Julie always make me feel welcome in addition to taking care of my dental questions, cleaning, and related billing.
Makes me feel like I’m family…service goes beyond than just dental care.
All staff has been pleasant to deal with.
Karen was friendly, professional, and efficient.
Very friendly office; a great manager at East Peoria office; a great implant doctor and the nurse, Ginger, who helps him! Highly recommend this place!!!
The people are very courteous and helpful.
Staff is friendly and courteous.
I absolutely love the attention to detail and the personality of the office staff!its a welcoming atmosphere!
Beautiful office! Very friendly staff who were knowledgeable and answered all of our questions. My daughter was able to get her braces on during our first appointment, and financing was so easy! Dr. W was very knowledgeable and had a great plan of action to make my daughter smile beautiful!
Linda is a great hygienist!
Jen does a really good job on the cleaning. awesome actually.