Dental Insurance

Do You Know the Drill?

Dental insurance is a way of helping you pay for your dental treatment. When you visit us at Montreal West Dentistry, it is our role to make a treatment plan based on your oral health needs. These needs may be different from what is covered by your dental plan with your insurance company. From our perspective, it is critical to that you make a decision based on what your oral health requires rather than what an insurance policy makes available to you.
 
Of course, it is your decision to go ahead with any treatment! When you decide to proceed with a dental treatment and schedule an appointment, this means that you have committed to paying for the treatment. It is critical to understand that the insurance company may change their decision of what percentage of the dental fees that will be reimbursed.  These and ALL decisions are between you and the insurance company. From time to time, the insurance company will send out a request for more details to the dentist. We complete these on our own time and return them to the insurance company.

Does this mean that the insurance company will now increase or decrease their coverage? 

Yes. These decisions are not ours, the decision is made by your insurance company!
 
Your dental insurance policy is a confidential document/agreement between you and your insurance carrier.

Montreal West Dentistry can:

  1. Transmit the treatment plan to the insurance company;
  2. Receive the insurance portion of the dental fees that have been identified to be paid;
  3. Respond to insurance inquiries.

 As a patient your responsibilities are to:

  1. Pay:
  • For your dental treatments in full at the completion of the appointment;
  • Any balance that occurs after a re-assessment by your insurance company.
 
  1. Receive communication about the treatment plans from your insurance provider

  2. Know what the frequency is for your check-up and cleanings.
  • If this has changed since your last visit;
  • Know your booked appointment falls in line with your coverage/your last appointment.

 
We’re always happy to help our patients! But we cannot stress enough that we are not permitted to make inquiries about your insurance or discuss with your carrier what is covered and why. 

Please check with your insurance carrier before your next dental appointment for any changes to your policy and let us know if we need to update your file.
 
Remember to have on hand the following information when you contact your insurance carrier:

  • Name of the subscriber
  • Employee’s date of birth
  • Social Insurance Number
  • Employer
  • Policy number
  • Division number and
  • Certificate number

Important questions to ask the dental insurance provider

  • What is the annual maximum dollars allowed per patient?
  • What is the anniversary date of the policy?
  • Is there an annual deductible? If yes, what is this amount?
  • How many units of scaling/root planning are covered on a yearly basis? What are the codes permitted?
  • How many recall appointments are allowed annually?
  • What percentage of coverage is allowed for the following services: diagnostic, preventative, restorative, endodontic, periodontal, and for crowns/bridges, dentures?

 

First Time Patients

Your first visit will be different from the rest of your appointments.  On your first visit, you will pay the entire fee for your treatment. We submit your insurance claim to your insurance carrier who will refund you directly (usually within five business days). 

Your next visits will be easier. We will take care of submitting the invoice and processing the claim. As mentioned above, you will remain responsible for whatever portion is not covered by your insurance policy.
 

Our flossify is to help you make the most of your dental coverage.