Dental insurance, direct billing and CDCP

Direct billing to your insurer

Direct billing means we send your claim to your insurance company electronically at the end of your visit. When your plan allows it, the insurer pays its share to the office, and you only settle the part your plan does not cover. You do not have to pay the full amount and wait for a cheque.

To set this up, bring your insurance card or the following details to your first visit:

• The name of the insurance company and the plan or policy number
• Your member or certificate number
• The plan member’s name and date of birth, if the coverage is through a spouse or parent
• Details of any second plan, so we can coordinate both

Most plans that accept electronic claims can be billed this way. A few plans only pay the plan member directly. If that is your case, we will give you a detailed receipt to send in yourself and tell you before the visit.

Canadian Dental Care Plan (CDCP)

We accept patients covered by the federal Canadian Dental Care Plan, and we bill the plan directly. If you have your member card, you can book with us as a new patient. Our CDCP page explains who qualifies, what the plan covers, which treatments need approval first and what to bring.

Predeterminations: knowing before you start

For larger treatment such as crowns, bridges, dentures, implants or root canal treatment, we can send a predetermination to your insurer before we begin. The insurer replies with what it expects to pay under your plan. It takes a little longer, but you know where you stand before you decide. For CDCP, some treatments need approval from the plan before they can start, and we send that request for you.

What affects what you pay

We do not post costs online, because what a visit involves depends on your teeth and your coverage. What you pay out of pocket depends on:

• Your plan’s coverage level for each type of care, which is often different for check-ups, fillings and major work
• Your annual maximum and how much of it you have already used this year
• Frequency limits, such as how often your plan pays for cleanings or X-rays
• Waiting periods some plans have for major treatment
• The treatment itself: the materials, the number of visits and whether a laboratory makes part of it
• Whether you have a second plan that can pay part of what the first plan does not

We explain all of this at the visit and put it in writing. You decide whether to go ahead, and nothing is added without your agreement.

If you have no dental insurance

You are welcome here without insurance. Start with an examination so we can tell you what needs attention now and what can wait, and we will give you a written estimate for the treatment you choose. It is also worth checking whether you qualify for the Canadian Dental Care Plan, especially if you are a senior, a parent of young children, or have recently lost workplace coverage.

Paying your share

Any part not covered by insurance or the plan is settled at the end of the visit. The front desk will go through the receipt with you, line by line, so you can see what your plan paid and what remains.

Help with paperwork

Insurance forms can be confusing, especially for older patients or families new to Canada. Our front desk team can help you read your plan booklet, check what a claim was paid, or fill in a form for a second plan. We provide care in English, French and Farsi and can communicate in American Sign Language.