Payment for services can be by Visa, MasterCard, Interac, cash or cheque.
We are more than happy to provide an estimate for your Insurance Dental Plan. Dental Plan designs are becoming more complicated and predicting reimbursement levels has become increasingly difficult. There are more than 30,000 dental plan contracts in Ontario; and each plan is slightly different from the next. Most plans have limitations that include the following:
- Annual deductible amounts.
- Frequency limitations of visits and procedures.
- Annual dollar maximums.
- Percentage of fees covered.
- Fixed fee guide (we charge current year fees, your plan may be fixed in the year it was ratified).
Having dental coverage can be a great benefit to you and your family but your dental plan is a contract between you, your employer, and the company providing the benefits.
As the patient, the payment for treatment fees is solely your responsibility.
Dental plans are designed to assist patients to pay for their dental treatment; however, not all treatments are eligible or fully reimbursable. It is important to understand that necessary treatment and covered expenses are not the same thing.
Insurance companies have become less co-operative when working with denture and dental offices. Denturists/ Dentists are often requested to supply supplemental information regarding treatment. More and more, insurance companies will only send payment cheques to the patient and refuse to send payment to the denturist/dentist. When our office attempts to contact the insurer for information on your behalf we are told that the information we desire is protected under PIPEDA, and that you, the client must request the information.
We will continue to submit claims for you by mail and electronically (when available). We will make every effort to ensure that claims are properly submitted for prompt reimbursement to you. We will also continue to submit predeterminations for major dental work that is deemed necessary to maintain your optimal oral health.
Remember, your dental insurance is not a treatment policy; it is a reimbursement plan. All treatment and care decisions should be made by you based upon actual needs, independent of your dental plan coverage.
In Ontario, most dental insurance policies are based solely on the Ontario dentists’ (ODA) general practitioner suggested fee guide. That fee guide refers only to one type - standard dentures; it does not offer a choice of higher quality dentures. Your Insurance Plan may pay a percentage of the suggested fee for standard dentures in that guide. That maximum benefit does not increase even if dentures of higher quality are being constructed.
The Denturists suggested fee guide (DAO) offers a choice of treatment – standard dentures, actually at a lower cost than standard dentures by dentists, or dentures of higher quality with slightly higher fees than what dentists charge for standard dentures.
Because most plans are based on standard dentures, they cover 50% of the cost of standard dentures in any dental office. However, your policy may not cover the full 50% for dentures of higher quality. If you choose dentures of higher quality you will have to contribute more towards the cost of your dentures, not because the fee is excessive but because the current contract is based solely on standard dentures. In addition, dental coverage may vary if the contract is tied to the year it was ratified. In our office we work on the Current Fee Guide but many payment schedules are 1-2 years behind.
The cost of precision dentures (mid-standard) from our office is only slightly higher than the total cost of standard dentures (minimal standard) from a dentist. As an oral health-care specialist, I can offer various types of dentures to satisfy each patient's specific requirements. To schedule your Free Consultation simply give us a call. You do not need e referral from your dentist.
30 Martha Street Suite 105
Bolton Professional Building
Monday - Thursday 9:00a.m.-5:00 p.m.
Friday 9:00a.m.-12:00 p.m.
Evening and House call appointments available.
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