Dental treatment is an excellent investment in an individual’s medical and psychological well being. Financial considerations should not be an obstacle to obtaining this important health service. Being sensitive to the fact that different people have different needs in fulfilling their financial obligations, we are providing the following payment options.
Finance Options
Convenient Payment Options
We accept Visa, MasterCard, American Express,
Alipay, Interac Debit, and WeChat Pay.
Patients Who Have Dental Insurance – We welcome dental insurance. We will be happy to answer all of your questions and call your insurance provider to verify benefits.
We will assist you by processing the insurance forms.
Things Every Insured Patient Should Know
Vital Information
- The name of the person in your company who is in charge of employee benefits
- Name of Insurance Carrier & Phone Number
Information patients will be asked to give when calling their insurance company:
- Name of subscriber
- Employee’s date of birth
- SIN number
- Employer
- Policy number
- Division number
- Certificate number
Questions Patients Should Ask About Their Insurance
- What is the annual maximum allowed per patient?
- What is the anniversary date of the policy?
Example: January 1st - Is there an annual deductible?
If yes, how much is it? - Dental benefits are paid on which year’s Ontario Dental Association fee schedule?
Example 1996 or 1999 - How many units of scaling and/or root planing are covered per year?
Which codes are allowed for these services? - How many Recall appointments are allowed annually?
Example every 3 months, 6 months 9 months? - What percentage of coverage is allowed for the following:
- Diagnostic services
- Preventive services
- Restorative services
- Endodontic services
- Periodontal services
- Major treatment
Example – crowns, bridges, dentures - Treatment Planning/Consultations
- What is the annual maximum for major treatment?
- Is Endodontic and/or Periodontal treatment classified as basic or major treatment?
Terms Insured Patients Should Know
Annual Maximum
Most insurance companies have an annual maximum amount of coverage for each patient listed under the insurance policy. This coverage may be changed and patients may not be informed.
Deductible
The dollar amount the patient pays toward their treatment before insurance coverage begins.
Eligibility
Eligibility determines who is covered under the insurance policy.
Exclusions
Many dental services and treatments that are clinically necessary are not covered by dental insurance. These exclusions are usually described in the patient’s insurance booklet, but you should be aware that more treatments are being excluded constantly to reduce costs.
Co-Payment
This “Out of Pocket Portions” are part of the treatment fee not covered by dental insurance. The insurance company will pay a certain percentage of the treatment, but they very rarely cover 100%.
Dual Coverage
This is when both spouses are covered by different insurance plans. The insurance companies usually coordinate the benefits so that the patient does not receive more than 100% of the cost of treatment.
Assignment
This is when the patient signs a section of the insurance form, which allows the dentist to receive payment directly from the insurance company, instead of having the patient pay the dentist and then wait for their insurance claim. However, patients are responsible for the “Out of Pocket Portion” at the time of treatment and any treatment that may no longer be a covered expense. Some insurance companies send payment directly to the patient. In such cases, assignment is prevented by the employer or the insurance company policy. Therefore payment arrangements must be made at the time of treatment.
Know Your Insurance
Some dental insurance benefits are changing rapidly, with many reductions in coverage.
Benefit coverage is a contract between a patient, the insurance company and your employer – not with the dentist.
Dental insurance companies do not inform dental offices of policy changes.
We suggest that you get updated information from your insurance company before making your dental appointments.
As a courtesy to our patients, we are happy to help you understand your insurance coverage.
Dental benefits may not cover 100% of your dentistry.
Coverage is being reduced drastically. This means that many necessary treatments may no longer be covered by your plan.
We encourage our patients to be familiar with their dental plan in order to eliminate disappointments with payment and reimbursement.
Some companies offer 100% coverage of 1994 fees – or less. We are charging current fees set by Ontario Dental Association which are higher than the average dental plan.
Our fees are based on our clinical expertise, the quality of care and materials provided.
If you have any questions regarding your coverage, we recommend that you call your insurace company. We would like you to avoid the disappointment of proceeding with the necessary treatment that the dentist has recommended, because you assume that is covered. If you later find out that your plan has changed, or that the treatment is no longer covered, you will be unhappy.
We are happy to offer our patients a pre-estimate of treatment fees, which can be sent to your insurance company for confirmation of your coverage. This will enable you to plan your finances, before commencing with treatment. We are pleased to discuss fees and payment options with you.
You need to be aware that insurance companies will sometimes send back approvals with a request for cheaper, alternative treatment plans. Our office is happy to discuss any alternatives and choices with you prior to treatment.
Some employers are offering their employees dental benefit programs which provide minimal coverage and limit the patient’s choice of a dentist and covered treatment.
Our team members are qualified to help you, if you have any questions.
