with a Focus on PreventionTM
Form No. 015-ID (7/07)
Contract Form No. 001-ID (7/02) IDAHO WASHINGTON OREGON NEVADA
For All of Your
Appointments or Emergencies
Toll Free .............................................. (800) 603-1738
Appointment Center Hours
Monday - Thursday .............. 7:00 a.m. - 8:00 p.m. PST
Friday ................................... 7:00 a.m. - 6:00 p.m. PST
Saturday .............................. 7:00 a.m. - 4:00 p.m. PST
Willamette Dental strives to keep dental costs affordable
for its patients. To achieve this, facilities are usually
operating at their fullest capacity. Schedules fill up Coverage
quickly and last-minute appointments are rare. It’s very
important to schedule appointments in advance. • No annual maximums
New patients are generally able to obtain their initial • No deductibles
appointment within 30 days of their call to the Willamette
Dental Appointment Center. Hygiene appointments • No waiting periods
generally have a wait-time of 45 days. Restorative • Extensive coverage on
treatment appointments generally have a wait-time of 60
days. These wait-times are averages. The length of wait-
time for an appointment may vary based on your choice • Low co-payments for
of provider, dental office location and your desired day major services
or time of appointment.
• Orthodontia with no age limit
Emergencies • 24/7 Emergency care
In the event of an emergency, call the Willamette Dental
Appointment Center at (800) 603-1738. Patients will
be seen within approximately 24 hours from the time
of scheduling an appointment for pain, bleeding, or
swelling. If your regular dentist is unavailable, you will be
scheduled with the first available dentist. High-Quality
To Change An Appointment
Please call the Willamette Dental Appointment Center • More than 30 years of
as soon as your plans change to reschedule your dental providing quality dental care
appointment. If you cancel with less than 24 hours • Clinical professionals
notice, then you will be charged a missed-appointment
that maintain one of the highest
fee. By giving us advance notice, we can schedule
another patient at the time that you are giving up. credentialing standards in the
Patient Relations (Customer Service) • Evidence-based dental care
Willamette Dental has a full staff of patient relations treatment philosophy
representatives who will answer any question that you
may have about your dental plan or service. • Most offices are open
Please reach us: Monday through Saturday,
Monday - Friday: ......................... 8 a.m. to 5 p.m. PST 7 AM to 6 PM
Toll Free:............................................... (877) 329-7965
E-mail: ........................ email@example.com
Website: ............................ www.WillametteDental.com
members receive their
dental care from a provider at a Willamette
Dental office. Our dentists, hygienists and
dental assistants are highly credentialed.
Each provider adheres to our evidence-based
With more than 60 offices throughout Idaho,
Washington, Oregon and Nevada, there is Quality
most likely an office near your home or work.
Once you have selected your dentist, all of
your appointments can be scheduled with
that same dentist. The exception would be for
emergencies or specialty referrals. Care
Approach To Dental Care
Willamette Dental has been providing quality In our practice, we use the best available
dental care to patients in the Pacific Northwest scientific evidence combined with clinical
for more than 30 years. Each provider upholds experience and patient circumstances to direct
our mission to deliver superior patient care treatment. Because of this evidence-based
through a partnership with our patients. approach, our dentists have moved away from
the role of repair technician and assumed a
Clinically, we strive to stop the dental disease/ broader role of healer. Dental care providers
repair cycle by implementing evidence-based assess risks and develop appropriate treatment
methods of prevention and treatment. To do so, plans for each patient.
each of our more than 660 dental professionals
have adopted today’s latest approaches to A key to this philosophy is our emphasis on
dental care that are supported by credible preserving the patients natural tooth-structure
scientific findings. and preventing dental disease. By using proven
techniques, including non-surgical methods
of treatment, our practitioners can help to
prevent or even reverse dental disease. As a
body of dental care professionals, our practice
emphasizes providing only the appropriate
treatment that will lead to the optimum oral
health of our patients.
Higher Standard Providers
Each clinical professional at Willamette
Dental has to meet and maintain one of the
highest credentialing standards in the dental
industry. The Willamette Dental Provider
Credentialing Policy ensures that providers
have the professional qualifications, licenses,
endorsements, certifications and permits
required by law, as well as meet our own
schedule of standards. All providers are routinely
evaluated to be sure their credentials are
current, and that they are working within their
appropriate scope of practice.
So that quality of care is the same throughout
our dental offices, every clinical professional
is a member of the Willamette Dental Quality
Assurance Program. This is how dentists,
hygienists and dental assistants regularly
receive updates on new products and
technological advances. In this program, dentists
receive regular peer reviews that monitor their
treatment planning and the documentation
of patient treatment. Knowing that the quality
of their treatment can be reviewed by their
colleagues is one of the most powerful
motivators for our dentists to continuously
practice our standard of quality dental care.
We use scientifically proven More so, these activities promote professional
development and enhance the capabilities of all
methods to help you preserve Willamette Dental providers.
your natural tooth structure.
A Focus On
Personal Dental Care Plan
Members of the Willamette Dental Plan are
encouraged to follow a Personalized Dental
Care Plan that is presented to them after their
You’ll be encouraged to follow a
first visit with their dentist. This program helps personalized dental program to
them to achieve and maintain good dental help you achieve and maintain
health. We have found that patients with good good dental health.
home health care habits can maintain their
natural tooth structure for a lifetime of healthy
gums and teeth.
Caries Management Therapy
In the past, dentists believed that the only
effective treatment for dental decay, also known
as caries, was to remove the diseased portion
of the tooth and replace it with a filling.
However, scientific studies have shown that
dental decay is an infectious disease caused
by a specific type of oral bacteria called
mutans streptococci, and that early areas of
decay can be reversed. Studies also show that
inappropriate or unnecessary removal of tooth
structure weakens teeth, which makes them
more susceptible to fracture. These findings
form the basis of Willamette Dental’s modern
Willamette Dental practices Caries (cavities)
Management Therapy, which identifies patients
at risk or potential risk of tooth decay and
provides appropriate therapeutic treatment. The
goal is to prevent decay and conserve natural
tooth structure through an intensive evaluation
and treatment regimen.
As part of their Personal Dental Care Plan
every new Willamette Dental member receives
a thorough risk assessment to determine
susceptibility to dental decay. Decayed tooth
surfaces are diagnosed and coded based
upon the level of decay penetration. Willamette
Dental dentists then make appropriate
treatment decisions from this examination.
In most cases, advanced areas of dental decay
will be restored using traditional filling materials.
Early areas of decay may be reversed and
re-mineralized utilizing antibacterial medications
and highly concentrated fluoride solutions. This
approach may require more frequent recall
appointments to treat the affected areas.
Questions & Answers
Can I sign up for the Willamette Dental What if I have an emergency?
plan and still go to my own dentist? Willamette Dental provides emergency services 24
Your dental care will ONLY be covered when hours a day, 365 days a year. If you experience an
provided by a dentist or specialist at a Willamette emergency situation (pain, bleeding or swelling), call
Dental office. Your coverage also extends if you are the Appointment Center toll free at (800) 603-1738.
referred to an outside dentist or specialist by your If necessary, you will be able to see a dentist within
Willamette Dental dentist. If referred to an outside approximately 24 hours. For emergencies during
dentist or specialist, your co-payments remain the regular office hours, you will pay the usual office-visit
same as shown in your Summary of Benefits. charge. After hours, the visit charge is usually higher,
as stated in your Summary of Benefits.
Can I choose one primary care dentist
to coordinate my care? Do office visit charges apply each time
that I have an appointment?
Yes, we encourage you to establish a long-term
relationship with a primary Willamette Dental Yes. The office visit charge, found in your Summary
dentist. Once you select your dentist, you may of Benefits, applies to all visits including
schedule all future appointments with them. You orthodontia. The office visit
are also free to change Willamette Dental dentists co-payment is in addition
or locations at anytime. to other co-payments that
you may accrue.
How do I schedule an appointment? Payments may be made
in cash, personal check,
To schedule an appointment, please call the or credit card. If you
Willamette Dental Appointment Center: are not yet a Willamette
Dental patient, cash
Toll Free .................................... (800) 603-1738 or credit card is the
preferred form of payment
Appointment Center Hours: until a relationship
Monday - Thursday:.......... 7 a.m. to 8 p.m. PST with your dentist is
Friday:................................ 7 a.m. to 6 p.m. PST established. All payments
Saturday:........................... 7 a.m. to 4 p.m. PST are to be made at the
time of service.
How long does it generally take
to get an appointment? What can I expect
at my first visit?
Willamette Dental’s scheduling
goals are as follows: During your first visit to
Emergencies: Within approximately 24 Hours our Willamette Dental
(pain, bleeding, or swelling) office, you will receive a
First Appointment: 30 days thorough examination that includes X-rays.
Regular Hygiene (Cleanings): 45 days At this time, your dentist will develop a Personal
Non-Emergency Operative Appointment: 60 days Dental Care Plan based upon your overall dental
health. Your dentist will then make recommendations
With the exception of emergencies, the number of days for cleanings, restorations, and other preventive
shown above are averages. The length of wait-time treatments needed to obtain optimal oral health
for an appointment may vary based on your choice of goals. Children will receive a cleaning at their
provider, dental office location and your desired day or first appointment and adults will receive their first
time of appointment.
cleaning after the initial appointment.
Will I receive two cleanings per year? What if I need to reschedule
Teeth cleaning frequency is determined at your an appointment?
first visit and is based upon the diagnosis made If you need to reschedule or cancel an
by your Willamette Dental dentist. Your Personal appointment, please call our Appointment Center
Dental Care Plan will outline the frequency as soon as possible. A missed appointment
and duration of your prescribed teeth cleanings fee is applied to your account for any missed
throughout the year. For example, a member with appointment without a 24-hour notice.
gum disease may be scheduled for cleanings
every three months, whereas a member with
healthy teeth and gums may only be required to
Can I get major work done right away?
have a cleaning once every 12 months.
The first priority is to diagnose and treat urgent
conditions that pose an immediate threat to
What if I have an emergency your oral health. The next priority is prevention;
which means controlling the disease process,
while I’m out of town? promoting wellness and helping you maintain
In Idaho, Washington, Oregon or good oral health. This assists in preventing
Nevada - If you’re traveling in our future deterioration of oral and dental tissues due
four state service area, call the to recurrent decay or progressive periodontal
Appointment Center at (800) 603- disease. Major restorative work is normally
1738 to make an appointment at performed once you have achieved a satisfactory
a Willamette Dental office. state of oral health and your teeth and supporting
structures are stabilized. This is the best way to
Outside our service area - If ensure the success of whatever major restorative
you cannot get to a Willamette work you may need.
Dental office, or if you are
traveling outside our service
area, you may go to any licensed Are orthodontia services available
dentist to obtain emergency
treatment; relief from pain, in every office?
bleeding, or swelling. Emergency Specialty services, including orthodontia, are
dental treatment is reimbursed generally available on a regional basis. To find out
up to the stated amount in your if a specialty service is available at your chosen
plan’s Summary of Benefits. office, simply contact our Appointment Center toll
Upon arriving home, contact our free at (800) 603-1738.
Patient Relations Department for
reimbursement. The maximum
amount that you will receive is Who do I call if I need more
listed in your Summary of Benefits.
You will need to schedule your
follow-up care with your Willamette Questions about your dental plan or service
Dental primary care dentist. should be directed to the Willamette Dental Patient
Relations Department. Please reach us:
Monday - Friday: .............. 8 a.m. to 5 p.m. PST
What happens if I change offices? Phone: ........................................ (877) 329-7965
Willamette Dental members have the freedom E-mail: ........... firstname.lastname@example.org
to receive dental care at any Willamette Dental
location. To change offices and/or dentists, call our
Appointment Center toll free at (800) 603-1738.
Please be aware that changing your dentist may
result in a treatment delay.
On the Web at
For the Entire Family
As part of your Willamette Dental Plan, an This comprehensive benefit includes full
orthodontia treatment benefit is available to consultation, X-rays, study models, case
members regardless of their age when treatment presentation, required appliances and follow-up
is performed by a Willamette Dental orthodontist. treatment. Throughout this treatment, our doctors
perform as clinical teams to give patients total
dental care oversight.
A member’s co-payment is determined by the
extent of the treatment required. The amount of
co-payment listed for Comprehensive Orthodontic
Services in the Summary of Benefits, plus office
visit charges, is the maximum amount that a
member will pay. In some cases, the co-payment
amount may be less. A major portion of the
orthodontic co-payment will be paid at the initial
banding appointment and the balance can then be
paid in twelve monthly installments.
Prior to orthodontic treatment, members are
required to meet with their primary care dentist,
who will refer them to a Willamette Dental
orthodontist for a pre-orthodontic consultation.
This consultation consists of three separate
meetings with a Willamette Dental orthodontist.
First the orthodontist performs an initial
examination of the patient’s bite and answers
any questions that they may have. At the next
appointment, we take X-rays and photographs,
as well as make models. The results of these
examinations are studied and a treatment plan is
developed. At the third meeting, the orthodontist
presents our recommendation of the best
treatment to re-align the patient’s teeth. Also,
they receive a comprehensive written estimate of
their treatment including its cost and a time-line of
Pre-orthodontic service co-payments are:
Initial orthodontic examination: ........ $ 25
Study models and X-rays: .............. $ 125
Case presentation: ............................ $ 0
Dental Care These non-refundable fees will be credited toward
the comprehensive orthodontic co-payment if the
member commences orthodontic treatment.
Throughout treatment, Willamette Dental
Please note: If the member’s coverage under the
doctors perform as a clinical team to plan terminates prior to completing orthodontia
give you total dental care oversight. treatment, then additional charges may apply.
Members should refer to their Certificate of
Coverage for orthodontia benefits and limitations.
Value Added Clinically Endorsed
Products Home Care Products
These value added products are offered through
Willamette Dental Providers. These products
are provided at a reduced fee and are not
insurance covered benefits. The member will
be responsible for all costs incurred.
Clinically Endorsed Products
Improve Your Home Dental Care
Willamette Dental has carefully selected dental
care products that are available to you at each
Willamette Dental office. We only offer those
products that have been clinically proven to
be the most effective at improving your dental
health. Through special arrangements with
manufacturers, we’re able to sell these products
to our patients at low prices.
Antibiotics & Pain Relief
• Willamette Dental provides a wide
selection of the most common and
• Prescription strength non-steroidal
anti-inflammatory and pain-relieving
drugs are available
Lozenges & Toothpaste
Teeth Whitening Fluoride Lozenges
Crest® Whitestrips • Fruit flavored, sugar free
• Professional strength without trays • Proven decay-fighting agent slowly released
• Comfortable, convenient and nearly invisible for longer lasting cavity prevention
• Excellent for patients with exposed root
Bleaching Kits surfaces and dry mouth symptoms
• Highly concentrated gel with custom trays
Power Tooth Brushes • Prescription strength fluoride toothpaste for
Sonicare® patients at high risk for dental decay
• Rapid bristle motions break up plaque • Great for patients with sensitive teeth
• Memory timer signals the Chlorhexidine Mouthwash
correct brushing interval • Prescription strength antibacterial
• High frequency bristle motion and dynamic mouthwash treats gingivitis, oral infection,
fluid cleaning action breaks up plaque and helps control the bacteria
BraunTM Oral-B® Xylitol Gum, Mints, Toothpaste & Mouthwash
• Combines two brushing motions • Natural flavoring agent clinically proven to
removes plaque prevent and reverse early decay
• Memory timer signals the correct • Helps prevent decay causing bacteria
brushing interval from sticking to teeth
The Following Services and • Conscious sedation/general anesthesia.
Supplies Are Not Covered: • Any condition resulting from military service or
declared or undeclared war.
• Any injuries sustained while practicing for or
competing in a professional athletic contest.
• Bleaching of a tooth.
• Cast dowel posts.
• Endodontics, bridges, crowns or other service
or prosthetic devices requiring multiple
treatment dates or fittings if treatment was
started or ordered prior to the Member’s
or Dependent’s effective date under the
Contract or if the item was installed or
delivered more than sixty (60) days after the
Member’s or Dependent’s coverage under the
Contract has terminated. Root canal treatment
will be covered if the tooth canal was opened
prior to termination and treatment is completed
within sixty (60) days after termination.
• Services or supplies by any person other than
& your family
a licensed dentist, licensed denturist, or
• Services or supplies that would have been
made or that the Member or Dependent would
have had no obligation to pay in the absence
of coverage under the Contract.
• Services or supplies incurred to comply with
Occupational Safety and Health Administration
• Full-mouth reconstruction.
• Orthognathic surgery.
• Cosmetic dentistry or surgery (not including
• Habit breaking or stress-breaking appliances.
• Dental implants or implant supported
• Excision of a tumor; biopsy of soft or hard
tissue; removal of a cyst or exostosis
• Dental services started prior to the date the
person became eligible for services under the
• Services for temporomandibular joint disorders.
• Extraction of permanent teeth for tooth
guidance procedures; procedures for
tooth movement, regardless of purpose;
correction of malocclusion; preventive
orthodontic procedures or other orthodontic
treatment, unless specifically provided in a
rider under the Contract.
• Investigational services or supplies.
• Materials not approved by the American
• Occupational injury or disease (including any
arising out of self-employment).
• Personalized restoration, precision
attachments, and special techniques.
• Prescription drugs, medications, or supplies.
• Repair or replacement of lost, stolen, or broken
• Replacements of an existing denture, crown,
or bridge less than five (5) years after the date
of the most recent placement.
• Replacement of sound restorations.
• Veneers; composite surfaces on posterior
• Services or supplies that are not
listed as covered under the Contract.
• Services to the extent that they are not
necessary for treatment of a dental injury or
disease or are not recommended and
approved by the licensed dentist attending the
Member or Dependent.
• To the extent that coverage is available under
any federal, state, or other governmental
program if application is duly made, therefore,
except where required by law such as cases
of emergency or for coverage provided by
• Intentionally self-inflicted injuries. The fact
that a person may be under the influence of
any chemical substance shall not be
considered as a limitation on the ability to form
• Occlusal guards.
• Services for accidental injury to natural teeth
that are provided more than twelve (12)
months after the date of the accident.
• Splints, nightguards, and other appliances
used to increase vertical dimension and
• Hospital or other facility care for dental
procedures, including physician services for
hospital treatment. However, subject to the
hospital co-pay as shown in your Certificate Of
Coverage, services of a Licensed Dentist
will be provided in a hospital or other facility
only when both the following requirements
Willamette Dental is proud to provide
are met: A) A hospital setting must be
medically necessary. B) The services must you and your family with extensive
be authorized, in writing, in advance by a dental coverage.
Contract Renewal and Termination Preventive and routine services are
The Contract will renew automatically from year covered at 100% and only require that
to year unless terminated as otherwise provided you pay a small co-payment per visit.
in the Contract. Termination of the Member or
Dependent under the Contract for any reason will
completely end all obligations of the company to
Most major services are covered at a
provide the Member or Dependent with Benefits low and predictable co-payment.
after the date of termination.
A Member becomes eligible for coverage under
the Contract after completing a probationary
period, if any, as designated by the Group.