Scheduling Appointments

• Jamestown Dental Clinic will make every attempt to accommodate every patient’s requested appointment time and day.
• When scheduling your appointments, we make every effort to keep you assigned to the dentist and/or hygienist who has been treating you.
• Preschool children should be seen in the morning because they are fresher, and we can work more slowly with the child for their comfort. School children with a lot of work to be done should also be seen in the morning for the same reason.
• Dental appointments are an excused absence. Please let us know if you need an excused absence letter for school for your child.

Canceling Appointments

In order to provide the best possible patient care, it is essential that we are given adequate notice regarding cancellations or change of appointments. Another patient who needs our care could be scheduled if we have sufficient time to notify them. We realize that unexpected things can happen, but we ask for your assistance in this regard.

The following guidelines should be followed in order to provide dental treatment to you or your family:

• Since appointed times are reserved exclusively for each patient, we ask that you please notify our office 24 hours in advance of your scheduled appointment time
• Appointment cancellations, changes or rescheduled appointments require 24-hour notice
• Prompt arriving for scheduled appointments is required. If you are late for your appointment, we may not be able to accommodate you
• Dental insurance verification and guardianship verification for minors must be presented at each appointment

Payment Plans and Financial Options

In order to provide the highest quality dental care available to all of our patients and to have those services comfortably affordable, we are pleased to offer you these options for payment:

• Preferred provider for Delta Dental and AppleHealth for children under the age of 20 (DSHS).
• We offer a same-day cash discount of 5% -or- 10% for seniors over the age of 65.
• Cash, checks, debit cards, VISA, MasterCard, and other major credit cards are accepted.
• Jamestown Family Dental Clinic is not able to finance individual payment plans. Instead, we partner with CareCredit to allow families with larger treatment plans to pay for their services over 12 months at 0% interest. Please ask our front staff for a brochure if you are interested in setting up a payment plan through CareCredit.

Insurance

Upon request, JFDC will bill your dental insurance for services provided. Insurance benefits are only an estimate and not a guarantee for dental coverage. When requested, a pre-authorization will be submitted for a guarantee of benefits. If dental insurance is paid directly to the subscriber, the responsible party will be required to pay for the costs of the services.

Responsible Party

The Jamestown Dental Clinic requires when a patient or legal guardian of a patient establishes an account, verification of the responsible party is required as well as being linked to the patient account. The social security number is the form of verification needed to identify the responsible party.

Financial Responsibility

The responsible party is financially responsible for all charges associated with services rendered. If it becomes necessary to pursue collections for any amount owed to JFDC, the responsible party will pay for all costs and expenses, including attorney fees and interest, or collection fees for overdue payments. The responsible party is required to pay all copays and deductibles at the time of service.

Legal Consent to Make Decisions

We understand everyone has a busy schedule and on occasion a family member or friend must accompany the minor scheduled for their dental visits. For everyone’s convenience, we offer a consent form for the legal guardian to sign for individuals to make decisions regarding care for a minor under the age of 18 years old during their visit. This form is available at the front desk.