INSURANCE, BILLING and PAYMENT

Dental Claim Submission

We submit all dental claims electronically (EDI) whenever possible, on your behalf. Manual claim forms are provided when electronic submission is not allowed under your dental plan.

When required, a pre-determination is sent to your insurer free of charge. We strive to maximize your insurance benefits whenever possible

Patient Insurance Information

We understand your desire to maximize your dental benefits – the benefits that either you or your employer has purchased on your behalf.

We hate to see patients disappointed when their benefits do not match their exact needs or expectations, so please let us help you understand your dental insurance, so that you have a better idea of what to expect.

Please keep in mind that we are a third party. We will gladly submit your claims electronically when possible as a courtesy to you (so that you are reimbursed quickly); however we are unable to tell you what your benefit package includes. That information is between you, your insurance company, and your employer, if applicable.

Dental insurance is meant to help you pay for/afford the cost of your dental treatment. It was never designed to cover the full cost of your dental treatment, all of the time. Its purpose is to alleviate some of the costs associated with treatment. We are very experienced in dealing with dental insurance and we are happy to share our knowledge with you. We’re happy to help you understand what benefits are available to you and to help you ask the appropriate questions of your insurance provider. Due to the always increasing privacy laws, we are unable to communicate directly with your insurance carrier and vice versa.

The package purchased for you was based on the amount either you or your employer budgeted for buying insurance – not on your specific needs or the needs of others in the plan. No one from the insurance company had any record of your dental history, or took your own unique needs into consideration. This is something only your dentist and hygienist will know, since they are your dental health care providers.

We do not recommend treatment based on your insurance coverage. We make recommendations based on what we know will be to your benefit, or what you clearly need. We want to treat you conservatively, bearing in mind the best long term prognosis. You will always be informed about the various options and outcomes, and ultimately the decision will always be yours.


Did You Know?

  •  Insurance companies never inform dental offices of changes to your policy.
  • Benefit coverage is a contract between you, the insurance company and your employer. Not the dentist.
  • Dental technology is always advancing, while most insurance plans are not. New and improved treatment options may not be an option under your plan.
  •  Some plans pay benefits based on older dental fee guides, this is quite common. We charge using the current fee guide. Your insurance company may only reimburse a certain percentage of a previous fee guide, so while the prices for dental treatment go up slightly every year, your coverage does not.
  •  We are happy to submit proposed treatment plans and estimates to your insurance to inquire about coverage, but they usually never send us a response. They will always send it to you, the patient.
  • We encourage you to know your plan, since we do not.
  • We recommend that you obtain updated information from your insurance company before making your dental appointments (and we would be pleased to help you further understand your benefit coverage).
  • Ultimately, you are responsible for paying the dentist for treatment and your insurance company will reimburse you.Please do not hesitate to ask should you have any questions or concerns.

We are here to help you.

Billing

How do we make up our fees?

Our fees are taken directly from the Ontario Dental Association Fee Guide for General Dentists, which is updated yearly.

Accepted forms of payment

Our office expects payment by Visa, MasterCard, Debit or cash when services are rendered, unless prior written arrangements have been made with the dentist and front-desk staff. 

We do not accept direct payment from insurance companies.

Our office accepts payment by