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 in regards to your billing and insurance questions. This will allow us to adequately facilitate the processing of your insurance.

Patient Forms

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


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, which could result in added finance charges on you 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 fee limitations on services. 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 of the insurance payment, it will be necessary that you make monthly payments in order to keep your account current. Please be aware that each patient will have a maximum insurance benefit each year.

Cash Account

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 prior to beginning 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 status of insurance payment.

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