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Enrollment Packet
Retirees Age 65 and over
The Harrison Trust
Evidence-Based Dentistry with a Focus on Prevention
WILLAMETTE DENTAL INSURANCE, INC.
OREGON
WASHINGTON
IDAHO
This is Willamette Dental
Contact Information
Appointments or Emergencies
Portland Metro Area:..............................(503) 644-3200
Outside the Portland Metro Area:............(800) 461-8994
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
Appointments
Willamette Dental strives to keep dental costs affordable
for its patients, therefore, facilities and staff are usually
operating at their fullest capacity. Schedules fill up
quickly and last-minute appointments are rare. It’s very
important to schedule appointments in advance.Our new
patients are generally able to obtain their initial appointment within 30 days of their call to our Appointment
Center; hygiene appointments are generally obtained in
45 days; restorative treatment appointments are generally
obtained in 60 days. The number of days shown above
are averages. The length of time to schedule an appointment may vary based on your choice of provider, dental
office location, and your requested day and time of
appointment.
Emergencies
In the event of an emergency, please call our Appointment
Center at (800) 461-8994. Willamette Dental patients will
be seen within 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.
To Change An Appointment
Our Dedication to Excellence
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•
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No annual maximums
No deductibles
No claim forms
Comprehensive dental coverage, including orthodontia
No age limit for orthodontia
Low cost for major services
Fixed-dollar (predictable) benefits and co-payments
Out-of-area emergency reimbursement
Call our Appointment Center at least 24 hours prior to
your scheduled appointment. With advance notice, we will
be able to schedule another patient at your appointment
time. Please note that you will be charged a “missed
appointment fee” if you cancel with less than 24 hours
notice.
High-Quality Dental Care
Patient Relations (Customer Service)
• Highly advanced equipment
Willamette Dental has a full staff of patient relations
specialists to answer your questions about dentists,
treatment plans, and procedures.
• In-house laboratory services (quality is closely
Patient Relations Contact Information
• Fully-staffed with patient relations
Monday - Friday:.......................... 8 a.m. to 5 p.m. PST
Portland Metro:.......................(503) 644-6444, Option 8
Toll Free:................................(800) 460-7644, Option 8
Email:[email protected]
Website:...............................www.willamettedental.com
• Most offices are open Monday through Saturday,
• Willamette Dental has been providing highquality dental care for more than 30 years
• Board-certified specialists
monitored)
representatives to address your questions and
concerns
7 a.m. to 6 p.m. PST.
www.willamettedental.com
Willamette Dental Insurance, Inc.
The Harrison Trust (Retirees 65 and over)
Summary of Benefits
Benefit
C o pa y m e n t
Annual Maximum
Deductible
Office Visit Copayment
No Annual Maximum
No Deductible
$5 per visit
Diagnostic and Preventive Services
Routine and Emergency Exams
All X-rays
Teeth Cleaning
Fluoride Treatment
Sealants
Head and Neck Cancer Screening
Oral Hygiene Instruction
Periodontal Screening
Periodontal Maintenance
$10
$45
$20
$15
$15
Covered at 100%
Covered at 100%
Covered at 100%
$10
Restorative Dentistry and Prosthetics
Fillings
Permanent Crowns
Complete Upper or Lower Denture
Bridge – per tooth
All lab fees
$30 to $80
$330 to $410
$430
$330
Covered at 100%
Endodontics and Periodontics
Root canal therapy – anterior
Root canal therapy – bicuspid
Root canal therapy – molar
Osseous Surgery – per quadrant
Root Planing – per quadrant
$200
$230
$275
$350
$70
Oral Surgery
Routine Extraction – Single Tooth
Surgical Extraction
$40
$65 to $80
Orthodontia
Pre-Orthodontic Service
Comprehensive Orthodontia (No waiting period)
N/A
No Ortho Benefit
Miscellaneous
Local Anesthesia (Novocain)
Nitrous Oxide (per visit)
After Hours Emergency Care
Missed Appointment Fee
Covered at 100%
$20
$20
$20
This is a summary of your benefits. Please refer to your certificate of
coverage for a complete description.
Affordable Care & Quality Benefits
Exclusive Providers
How Do We Keep Dental Care Affordable?
Willamette Dental members are required to receive
their dental care from a provider at a Willamette
Dental office. Our dentists and staff are fully
employed by Willamette Dental and adhere to the
evidence-based treatment philosophy based on the
most current scientific research to help you
preserve your natural tooth structure.
Focus on Prevention - As a member of the Willamette
Dental Plan, you’ll be encouraged to follow a personalized
dental maintenance program to help you achieve and
maintain good dental health. This helps minimize the
need for expensive dental services that would otherwise
drive up your out-of-pocket costs. We believe that
patients with good home healthcare habits have the
ability to maintain their natural tooth structure for a
lifetime of healthy teeth.
With more than 50 offices conveniently located
throughout Oregon, Washington, and Idaho, there
is probably an office right in your neighborhood. All
of your appointments should be scheduled with the
same dentist, except for emergencies and
specialty referrals.
Office Efficiency - Willamette Dental makes the fullest
possible use of all of our facilities and staff because we
know that empty chair space means higher costs for our
patients. That’s why it’s important to schedule
appointments and routine procedures well in advance as
well as cancelling appointments promptly.
Quality and Affordability
Willamette Dental prides itself in providing you and
your eligible dependents with comprehensive
dental coverage (including orthodontia) at a cost
that is significantly lower than typical fee-forservice dental plans.
• All preventive and routine services (including
orthodontia) are covered by our dental plan and
require that you pay only a small co-payment
per visit (depending on your plan).
• Co-payments for most major services
(prosthetics) are substantially lower than
comparable fee-for-service plans.
• Most co-payments are fixed-dollar amounts (not
percentages), so you know your exact out-ofpocket costs.
The Bottom Line
A Focus on Prevention - minimizes expensive dental services that drive up costs
Small Co-payments for Office Visits - you know exact out-of-pocket costs
Over 50 offices in the Tri-State Region - we are conveniently located throughout Oregon, Washington, and Idaho
A Healthier Approach to Dental Care
The Advantage of Caries Management
Therapy (CMT)
Dental schools have traditionally taught (and dentists
therefore believed) that the only effective treatment for
dental decay (also known as caries) is to remove the
diseased portion of the tooth and replace it with a filling.
However, recent studies show 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 and makes them more susceptible to
fracture. These and other findings form the basis of
Willamette Dental’s modern treatment philosophy.
Willamette Dental practices Caries (cavities)
Management Therapy (CMT), 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.
Every new Willamette Dental member receives a thorough
risk assessment to determine susceptibility to dental
decay. In addition, decayed tooth surfaces will be
diagnosed and coded based upon the level of decay
penetration. Willamette Dental dentists will then make
appropriate treatment decisions from information gathered
from this examination.
Advanced areas of dental decay will be restored utilizing
traditional filling materials and methods. Early areas of
decay will 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.
The Bottom Line
We use the most current scientific information to
help you preserve your natural tooth structure,
which is beneficial to your long-term dental health
and your bottom line.
Questions and Answers
Here are some questions frequently asked by Willamette Dental plan members. If you don’t find an answer to your
specific question, please inquire with your benefits administrator.
Q. Can I sign up for the Willamette Dental plan and still
go to my own dentist?
A. Your dental care will ONLY be covered when provided by a
dentist or specialist at a Willamette Dental office. Your
coverage also extends if it is referred to an outside dentist
or specialist by your Willamette Dental dentist. If referred to
an outside dentist or specialist, your co-payments remain
the same as shown in your Summary of Benefits.
Q. Can I choose one Willamette Dental primary care
dentist to coordinate my care?
Q. What if I have an emergency?
A. Willamette Dental provides emergency services
24 hours a day, 365 days a year. If you
experience an emergency situation (pain,
bleeding or swelling), call the Appointment Center
at (503) 644-3200 in the Portland Metro area or
toll free at (800) 461-8994. If necessary, you will
be able to see a dentist within 24 hours. For
emergencies during regular office hours, you will
pay the usual office-visit charge. After hours, the
visit charge is usually higher, as stated in your
Summary of Benefits.
A. Yes, we encourage you to establish a long-term
relationship with a primary Willamette Dental dentist. Once Q. Do office visit charges apply each time I
have an appointment with a dentist or
you select your dentist, you may schedule all future
specialist?
appointments with him/her. You are also free to change
Willamette Dental dentists or locations at anytime.
A. Yes. The office visit charge,
found in your Summary of
Q. How do I schedule an appointment?
Benefits, applies to all visits
including orthodontia. The
A. To schedule an appointment, please call our Appointment
office visit co-payment is in
Center:
addition to other co-pays that
you may accrue.
• Portland Metro Area:.....................(503) 644-3200
• Outside the Portland Metro Area: (800) 461-8994
Payments may be made in
cash, personal check, or
Q. Appointment Center Hours:
credit card. If you are not yet
a Willamette Dental patient,
A. • Monday - Thursday:...................7 a.m. to 8 p.m. PST
cash or credit card is the
• Friday:...................................... 7 a.m. to 6 p.m. PST
preferred form of payment
• Saturday:...................................7 a.m. to 4 p.m. PST
until a relationship with your
dentist is established. All
Q. How long does it generally take to get an
payments are to be made at
the time of service.
appointment?
A. Willamette Dental’s tri-state scheduling goals are as follows:
• Emergencies: Within 24 Hours (pain, bleeding, or swelling)
• First Appointment: 30 days
• Regular Hygiene (Cleanings): 45 days
• Non-Emergency Operative Appointment: 60 days
With the exception of emergencies, the number of days
With the exception of emergencies, the number of days
shown above are averages. The length of time to schedule
shown above are averages. The length of time to schedule
an appointment may vary based on your choice of provider,
an appointment may vary based on your choice of provider,
dental office location, and your requested day and time of
dental office location, and your requested day and time of
appointment.
appointment.
Q. What can I expect at my
first visit?
A. During your first visit to our
Willamette Dental office, you will receive a
thorough examination that includes x-rays. At
this time, your dentist will develop a Personal
Dental Care Plan based upon your overall dental
health. Your dentist will then make
recommendations for cleanings, restorations, and
other preventive treatments needed to obtain
optimal oral health goals. Children will receive a
cleaning at their first appointment and adults will
Q. What if I need to reschedule an appointment?
receive their first cleaning after the initial
appointment.
A. If you need to reschedule or cancel an appointment, please
call our Appointment Center as soon as possible. A missed
appointment fee is applied to your account for any missed
appointment without a 24-hour notice.
Q. Will I automatically receive two cleanings per year?
Q. Can I get major work done right away?
A. Teeth cleaning frequency is determined at your first visit
and is based upon the diagnosis made by your Willamette
Dental dentist. Your Personal Dental Care Plan will
outline the frequency and duration of your prescribed teeth
cleanings throughout the year. For example, a patient with
gum disease may be scheduled for cleanings every three
months, whereas a patient with healthy teeth and gums
may only be required to have a cleaning once every 12
months.
A. The first priority is to diagnose and treat urgent
conditions that pose an immediate threat to your
oral health. The next priority is prevention - which
means controlling the disease process, promoting
wellness, and helping you maintain good oral
health. This is essential to prevent future
deterioration of oral and dental tissues due to
recurrent decay or progressive periodontal
disease. Major restorative work is normally
performed once you have achieved a satisfactory
state of oral health and your teeth and supporting
structures are stabilized. This is the best way to
ensure the success of whatever major restorative
work you may need.
Q. What if I have an emergency while I’m out of town?
A. Emergency dental treatment is
reimbursed up to the stated amount
listed in your plan’s Summary of
Benefits.
In Oregon, Washington or Idaho - If
you’re traveling in our tri-state service
area, first call the Appointment Center at
(800) 461-8994 to schedule an
appointment at the nearest Willamette
Dental office.
Outside our service area - If you cannot
get to a Willamette Dental office, or if you
are traveling outside our service area, you
may go to any licensed dentist to obtain
emergency treatment (relief from pain,
bleeding, or swelling). Upon arriving
home, contact our Patient Relations
Department for reimbursement. The
maximum amount you will receive is
listed in your Summary of Benefits. Also,
you will need to schedule your follow-up
care with your Willamette Dental primary
Q.
care dentist.
Q. What happens if I change offices?
A. Willamette Dental members have the freedom to receive
dental care at any Willamette Dental location. To change
offices and/or dentists, call our Appointment Center at
(503) 644-3200 in the Portland Metro area or toll free at
(800) 461-8994.
Please be aware that changing your dentist may result
in a treatment delay.
Q. Are orthodontia services available in
every office?
A. Specialty services, including orthodontia, are
generally available on a regional basis at a
location that is convenient for most of our
patients. To find out if a specialty service is
available at your chosen office, simply contact our
Appointment Center at (503) 644-3200 in the
Portland Metro area or toll free at (800) 461-8994.
Q. Who do I call if I need more information?
A. Questions about dentists, treatment plans, and
procedures should be directed to the Patient
Relations Department at Willamette Dental.
Patient Relations Department
Hours of Operation:
Monday - Friday:...............8 a.m. to 5 p.m. PST
Phone:.........................(800) 460-7644, Option 8
Email:[email protected]
Website:....................www.willamettedental.com
Provider Services
Retail Products and Services
Willamette Dental is pleased to offer patients a variety of
highly effective dental products and services.
We have carefully selected and tested a number of
products that have been clinically proven to be the most
effective among those found on the market today.
Teeth Whitening
Crest ® Whitestrips
• Professional strength without trays
• Comfortable, convenient, and nearly invisible
Bleaching Kits
• Highly concentrated gel with custom trays
Power Toothbrushes
Sonicare ®
• Rapid bristle motions break up plaque
• Memory timer guarantees the correct brushing interval
• High frequency bristle motion and dynamic fluid cleaning
action breaks up plaque
“Your prescription “whitening strips” worked great. Much better
than the over-the-counter ones I bought from my pharmacy.
Thank you Willamette Dental.”
Braun TM Oral-B ® 3D Excel
• Combines two brushing motions removes plaque
• Memory timer guarantees the correct brushing interval
Prescription Lozenges & Toothpaste
Fluoride Lozenges
• Fruit flavored, sugar free
• Proven decay-fighting agent slowly released for longer
lasting cavity prevention
• Excellent for patients with exposed root surfaces and dry
mouth symptoms
Toothpaste
Jeri W.
Willamette Dental Patient
Xylitol ® Gum, Mints, Toothpaste & Mouthwash
• Natural flavoring agent
•
clinically proven to prevent
and reverse early decay
Helps prevent decay
causing bacteria from
sticking to teeth
Antibiotics & Pain Relief
• Prescription strength fluoride toothpaste for patients at
high risk for dental decay
• Great for patients with sensitive teeth
Chlorhexidine Mouthwash
• Prescription strength antibacterial mouthwash treats
gingivitis, oral infection, and helps control the bacteria
that cause tooth decay
Antibiotics
• Willamette Dental provides a wide selection of the most
common and effective antibiotics
Pain Relief
• Prescription strength non-steroidal anti-inflammatory
and pain-relieving drugs are available
Willamette Dental’s products and services are available only to our current patients. Because of established relationships
we’ve created with a number of manufacturers, we are able to provide you with these quality products at low prices. The
products described above are not a covered benefit under Willamette Dental Insurance, Inc.
Provider Services
Implants
Implants have become an accepted standard of care for the
replacement of missing teeth. Patients with healthy gums,
good bone structure, and excellent oral hygiene habits are
usually excellent candidates to receive dental implants.
Dental implants are titanium metal posts surgically placed
in the bone. Implants fuse to surrounding bone tissue and
offer a secure foundation to support an individual missing
tooth and/or dentures. Advances in technology, surgical
procedures, and restorative techniques have made implants
highly successful and relatively easy to place.
Willamette Dental implant services are limited to surgical
placement of implants where the bone and soft tissues are
sound and healthy. In situations where bone and tissues are
less than ideal for implant procedures, additional surgeries
may be required to improve the site in order to support an
implant. Additional surgery may include additional costs to
the patient.
The treating Willamette Dental dentist reserves the right to
determine the suitability of implant therapy and whether
therapy will be initiated.
Implant services are offered through Willamette Dental
providers at a reduced fee and are not a covered benefit
under Willamette Dental Insurance, Inc. The services and
fees are available only when a Willamette Dental general
dentist or specialist performs the entire treatment. Patients
receiving treatment for Willamette Dental implant services
will be responsible for all fees.
Frequently Asked Questions
Q.
Are there office visit charges for dental
implant appointments?
A.
No. At the end of your initial consultation, you
will receive a written estimate of charges to
cover the recommended treatment procedures.
Q.
A.
Who should I contact if I have more
questions?
Contact the Willamette Dental Patient
Relations Department. In the Portland metro
area call (503) 644-6444 option 8, or if outside
the Portland metro area call (800) 460-7644,
option 8. In Washington, please call (800) 3601909.
Locations in Oregon
SURGICAL OFFICES
Portland
405 SE 133rd
Portland, OR 97233
(503) 644-6545
(800) 209-2686
Eugene
2703 Delta Oaks Drive
Eugene, OR 97408
Tigard
11415 SW Scholls Ferry Road
Beaverton, OR 97008
RESTORATIVE OFFICES
Portland
220 NE Weidler Street
Portland, OR 97232
Tualatin
17130 SW Upper Boones Ferry Rd.
Durham, OR 97224
Corvallis
2420 NW Professional Drive
Suite 150
Corvallis, OR 97330
Springfield
2073 Olympic Street, 3rd Fl.
Springfield, OR 97477
Medford
773 Golf View Drive
Medford, OR 97504
Salem
4755 LIberty Road S.
Salem OR 97302
Over 50 Convenient Locations
*Offices scheduled to open in January 2006
Appointment Center:
Appointment Center Hours:
Portland Metro:............. (503) 644-3200
Toll Free:........................ (800) 461-8994
Monday - Thursday: .... 7 a.m. to 8 p.m. PST
Friday:..............................7 a.m. to 6 p.m. PST
Saturday:.........................7 a.m. to 4 p.m. PST
The Insurance Company
The Providers
Willamette Dental Insurance, Inc. (WDI) is pleased
to provide you and your eligible dependents the
opportunity to enroll in WDI’s dental plan. WDI is a
family of affiliated companies, and together, we are
one of the largest managed care providers in the
Northwest.
Our professional general practitioners, specialists,
hygienists, and quality support staff provide
excellent care for our patients in Oregon,
Washington, and Idaho.
We provide dental insurance and dental services to
members throughout Oregon, Washington, and
Idaho. Our reputation for providing affordable dental
coverage with outstanding customer service has
made us the clear choice in dental care treatment.
Through education about prevention, the
implementation of good home healthcare habits
and Caries (cavities) Management Therapy, our
members have the ability to reduce the need for
frequent visits to the dentist.
Exclusions
This is a summary of limitations and exclusions. Please refer to your Certificate of Coverage for a complete description.
These Services and Supplies Are Not Covered:
• Conscious sedation/general anesthesia.
• Investigational services or supplies.
• Any condition resulting from military service or
• Services for temporomendibular joint disorders.
declared or undeclared war.
• Bleaching of a tooth.
• Materials not approved by the American Dental Association.
• Occupational injury or disease (including any arising out of
• Cast dowel posts.
• Charges by any person other than a licensed dentist,
licensed denturist, or licensed hygienist.
self-employment).
• Personalized restoration, precision attachments, and
special techniques.
• Charges that would have been made or that the patient • Prescription drugs, medications, or supplies.
would have had no obligation to pay in the absence of
this coverage.
• Charges incurred to comply with Occupational Safety
and Health Administration (OSHA) requirements.
• Full-mouth reconstruction.
• Repair or replacement of lost, stolen, or broken items.
• 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.
• Orthognathic surgery.
• Veneers; composite surfaces on posterior teeth.
• Cosmetic dentistry or surgery (not including
orthodontia).
• Habit breaking or stress-breaking appliances.
• Dental implants or implant supported prosthetics.
• Services or supplies that are not listed as covered.
• 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 patient.
• Excision of a tumor; biopsy of soft or hard tissue;
removal of a cyst, or nonodentogenic.
• Dental services started prior to the date the person
became eligible for services.
• 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.
• 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 Medicaid.
• Splints, nightguards, and other appliances used to increase
vertical dimension and restore bite.
• 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 are met:
• A hospital setting must be medically necessary.
• The services must be authorized, in writing, in
advance by a Participating Dentist.
Printed 9/05
Dental Services Provided by:
WILLAMETTE DENTAL
Underwritten by:
WILLAMETTE DENTAL INSURANCE, INC.
Marketing • 14025 SW Farmington Rd. • Beaverton, OR 97005 • www.willamettedental.com
© Copyright 2005, Willamette Dental. All rights reserved.
Marketing
• 14025 SW Farmington Rd. • Beaverton, OR 97005 • www.willamettedental.com
®
Willamette Dental is a trade-name in use by the Willamette Dental affiliated companies. These companies include: Willamette Dental
Insurance, Inc., an Oregon dental insurance company; Willamette Dental of Washington, Inc., a Washington dental insurance
company; Willamette Dental of Idaho, Inc., an Idaho dental insurance company; Willamette Dental Group, P.C., a dental practice
operating in Oregon and Idaho, and Eugene C. Skourtes, Inc., P.S., doing business as Willamette Dental Group, a dental practice
operating in Washington.
© Copyright 2004, Willamette Dental. All rights reserved.
Crest, Sonicare, Braun, and all other trademarks are the property of their respective owners.
Crest,
Braun,have
and been
all other
are permission
the propertyfrom
of their
respective
owners.
Logos
and Sonicare,
product images
usedtrademarks
with express
authorized
representatives.
Logos and product images have been used with express permission from authorized representatives.