Discussing the cost of treatment is one of most uncomfortable part of a patient visit for dentists and staff. However, we will always discuss costs with honesty and openly, so that misunderstandings and conflicts can be avoided.
As a courtesy to our patients, unlike many dental offices in Toronto, we follow the current Ontario Dental Association Fee Guide regarding the costs for the majority of dental procedures we perform in our office.
Our office accepts payments directly from your insurance company if your insurance allows for it. When you receive dental treatment, you are only required to pay the difference between the amount shown on the bill and the payable benefit covered by your insurance.
Westmount Dental and Your Insurance Plan – How They Work Together:
We are pleased that you have insurance benefits to help with the cost of your dental care. We would like to help you obtain the maximum use of this benefit. The following are variables associated with insurance plans that can influence the extent of your benefit.
Dental insurance is a contractual agreement between you and your insurance company and in no way is an agreement with our dental office. The terms of the dental plan and the extent of your coverage depends on the benefit package your employer has purchased for you.
The following are areas that you should become familiar with, in regards to your individual coverage and your financial obligations.
Yearly deductibles – Most insurance plans require that you pay a deductible amount each year on the anniversary date of your policy.
Treatment Percentage Coverage – Most insurance plans do not pay 100% for all types of treatment; some plans do not pay at all for certain procedures and most pay a percentage for different treatments.
Fee Guide – Fee guides are established yearly by the Ontario Dental Association. Our office is on the current year’s fee guide. Not all insurance plans pay their claims on the current fee guide but instead may pay a lesser fee.
Clearly, not all treatment billed to you by us may be reimbursed 100% by your insurer. The patient is ultimately responsible for all fees charged by our office.
Let us help you understand your insurance policy
Due to the current privacy legislation, insurance providers are no longer allowed to release your private information if we contact them on your behalf. However, we require information from you so that you can know the extent of coverage for a particular treatment.
We can help you keep track of your benefit used by providing you with accurate statements when needed. We can send requests for an Estimate of Coverage (“Predetermination”) on your behalf for dental treatment, so that you will know your exact coverage before making your final treatment choice.
Ultimately, we are treating you as patient, and not “treating your insurance plan.” It is important that you recognize that your insurance plan is a legal contract between YOU and YOUR INSURANCE COMPANY. Our office is not, and cannot be, a part of that legal contract. Ultimately, you are responsible for all charges incurred in our office.