you are a new patient to our office, please print and fill out the
forms below. Bringing them with you will allow us to attend to your
dental needs more quickly than completing them on your arrival to the
office. Thank you and please call us if you have any questions.
We are Preferred Providers for the following dental insurances:
Delta Dental PPO
Delta Dental Premier
Delta Dental AARP
Issaquah Family Dental gladly accepts all major PPO dental Insurance plans.
Office Policies and Financial Agreement
It is our goal for patients to clearly understand their treatment needs, as well as their financial responsibility, before treatment begins. Payment of estimated patient portion is due at the time of treatment. We desire to make dental treatment affordable to all of our patients. Therefore, we offer the following payment options, in lieu of or in addition to, your Dental Insurance:
1. Flexible payment plans of up to 36 months upon approval with Care Credit®.
2. Cash, Check, Amex, Visa, MasterCard or Discover Card
3. In-Office financing with Credit/Debit Card on file (some exclusions apply-call for details)
As a courtesy to you we will gladly process your insurance claim forms. Our responsibility is to provide you with the treatment that best meets your needs, not to try to match your care to insurance plan limitations. Dental insurance plans do not correspond to individual patient needs, and as such, many routine and necessary dental services are not covered even though you may need those services.
We understand insurance guidelines can be hard to understand and overwhelming at times. Fortunately with the information provided to us by you and your insurance company we are able to provide some assistance in estimating your insurance benefit. However, your insurance company makes final determination once treatment is completed and the claim is submitted. Due to pending claims and patient privacy issues, we do not always know how much an insurance company has already paid to another office or specialist, and the balance remaining on a yearly maximum. Your insurance is a contract between you and your insurance company; therefore, all charges are your responsibility.