Patient Information

The following information is provided for the convenience of our patients. We hope to provide you with a complete understanding of our financial policies and will be happy to answer any questions you may have regarding your billing and insurance questions. This will allow us to adequately process your insurance.

Patient Forms

Please download, print, and fill out the following forms and bring them with you to your first appointment.

• Dental History
• Patient Information
• Medical History

Insurance

As a courtesy to our patients, we will bill your insurance company(s). It is your responsibility to provide our office with the correct insurance information. Incorrect information may delay the insurance payment, resulting in added finance charges on your account or the denial of your claim. Most insurance companies will cover 50-80% of dental procedures.

We ask that you pay your estimated portion at the time of service.

Insurance companies use the term “Usual and Customary” when setting service fee limitations. The term suggests, but does not necessarily reflect, the average fees charged by dentists in the community. Insurance companies offer several different fee schedules depending on the plan that your employer has purchased. Our fees are filed with Washington state and are the “Usual and Customary” for the Spokane area. Please be aware that some insurance companies will pay a claim percentage based on their fee schedule and not our actual fees.

The insurance contract is between the subscriber and the insurance company. Therefore, if there are any problems or claim rejections, we ask that you deal directly with your insurance company, as you are ultimately responsible for any charges incurred. We will be happy to help you as much as possible with any information regarding your claim. If there is a delay in the insurance payment, you will need to make monthly payments to keep your account current. Please be aware that each patient will have a maximum insurance benefit each year.

Cash Accounts

For our patients without insurance, we offer a 5% discount for payment in full on the day of service. If you are unable to pay for your treatment on the day of service, please discuss financial arrangements with our financial coordinator before your treatment.

Credit Cards

We accept VISA and MasterCard

A service charge of 1.5% will be assessed for any balance remaining after 90 days, regardless of the status of insurance payments.

For more information or to make an appointment, please give us a call (509) 534-0428.