We deliver the finest care at the most reasonable cost to our patients. Payment is due at the time service is rendered, unless other arrangements have been made in advance. For your convenience we accept interact (Debit), cash, e-transfer, Visa and Master Card. Feel free to contact our office if your treatment plan requires more comprehensive dental work and you want to discuss financial arrangements.
What Is Dental Insurance & How Does It Work?
Dental Insurance is a contract between your employer and a dental insurance company. The benefits you will receive are based on the terms of the contract that were negotiated between your employer and the dental insurance company and not your dental centre.
We are here to assist you with calls to your insurance company, in your presence, to determine eligibility and coverage, and to assist with predeterminations as well. We believe an informed patient will utilize their dental benefits, which maximizes their overall health.
We are pleased to accept most dental insurance plans for dental treatments. Electronic claims processing is also available and our helpful office administrators will be happy to file your claim.
We are also pleased to assist you in better understanding and managing your insurance coverage, however due to privacy regulations and limitations, it is the patients’ responsibility to provide our office with up to date insurance coverage breakdowns. Claim history will be required if you have received treatment outside our practice. A plan may include specific inclusions and exclusions that we will not know of in advance; therefore, it is important for the patient to understand his/her dental benefits.
Covered & Non Covered Services
Unfortunately, your dental insurer will not cover some of the services that you may need or want. Our goal is to help you achieve and maintain optimal dental care, which is not necessarily the goal of your insurance company.
Dental insurance companies rarely cover 100 percent of any dental fee and, in many cases, cover less than 50 percent or nothing at all. Many insurance plans have a dollar amount limitation each year. Once this limit is reached, your dental insurance company regardless how essential the service may be to your dental health will cover no other services.
Please remember even though we bill your insurance company on your behalf, any remaining balance after your insurance company’s payment is your responsibility. For all major work, we always send an estimate to obtain approval from the insurance company before treatment is initiated.
To have a better understanding of your insurance policies, here are some commonly used insurance terms to know:
ANNUAL MAXIMUM - This is the maximum amount of annual coverage you have under your insurance policy. Please keep in mind that this coverage can be changed by your provider so it is important to stay up to date with any changes.
DEDUCTIBLE - The amount that you pay for your treatment prior to when your coverage begins.
ELIGIBILITY - The parameters that determine who is eligible to be covered under the insurance policy.
EXCLUSIONS - It's likely that not all dental treatments and services are covered by your dental insurance. These exclusions are because insurance companies want to save money. Be sure to go over your insurance booklet to check what services and treatments are covered.
CO-PAYMENT - Dental insurance rarely covers 100% of total fees for treatments or services. Co-payment is the amount of a treatment fee that you are expected to pay for that is not covered by your dental insurance.
Depending on your plan, an 80/20 co-payment is common for basic procedures such as x-rays, cleaning, fillings and root canals. This means that the dental plan covers 80% of the bill. A 50/50 co-payment is common for major procedures such as crowns and bridges.
But there are many variations; be sure to check your specific plan.
DUAL COVERAGE - when both you and your spouse are covered by different insurance plans. The insurance companies will then work out the benefits so that you don’t have to pay for more than 100% of the treatment’s fees.
Can my dentist waive my co-payment?
No. The waiving of a co-payment is insurance fraud and is against the law. Your dentist could be heavily fined or even lose their license. When you and your dentist sign the claim form that goes to the insurance company, you are stating which services were provided and how much, in total, was charged. The insurance company pays its share based upon the assumption that you will do the same.
How Our Office Helps
We will do everything possible to help you understand and make the most of your dental insurance benefits. Our office will complete and submit dental insurance forms to the company to achieve the maximum reimbursement to which you are entitled and will work diligently to make this happen as quickly as possible. We will help you every step of the way to ensure your visit is stress free! We thank you for allowing us to take care of your dental needs and look forward to serving you!