Our Dental Insurance Policy
Updated December 8, 2023
What Is Dental Insurance?
Dental insurance is a type of health coverage specifically designed to help individuals manage the costs associated with dental care. It is typically structured to cover a portion of the costs incurred for dental treatments, reducing the out-of-pocket expenses for the policyholder. Some patients will buy their own dental plan, but most have dental benefits provided by their employer. Your dentist may not be familiar with your specific plan coverage so it’s important to know how your plan works. Always read the information booklet or other materials available from your benefits provider.
Before going to your dentist to utilize your dental insurance benefits, there are some things that you should know as a patient:
- Dental Insurance Policy at Atlas Dental
- Understanding The Terminology Of Your Dental Insurance Coverage
- Leading Dental Insurance Companies in Canada
Claiming Dental Expense Tax Credit On Your Canadian Tax Return
We believe that clear communication about our insurance policies helps foster a positive and trusting relationship with our patients. If you have any further questions regarding our insurance procedures, payment options, or if you require assistance with the claims process or want to know more about the dental services offered at Atlas Dental, please contact us.
Dental Insurance Policy at Atlas Dental
At Atlas Dental, we are committed to providing exceptional dental care and ensuring a seamless experience for our valued patients. As part of our commitment to transparency and efficiency, it’s essential for our patients to be informed about our dental insurance policy.
Your Dentist’s Responsibilities
Dentists make their treatment plan based on your dental needs. Sometimes, your dental plan coverage and your treatment plan won’t align. If your dental plan only covers part of the cost of your treatment plan, you’ll need to cover the rest as an out of pocket expense.
Your dentist will take you through your personalized treatment plan and answer any questions you may have. They can also help you understand how much may be covered before you move ahead by submitting a predetermination form to your dental benefits administrator. Your benefits administrator will provide you with a “predetermination of benefits”. This doesn’t guarantee that the treatment will be covered by your health insurance plan. But it will show you what services are covered and the limitations of your plan.
Remember that your dentist is treating you, not your dental plan. Read more about your dentist’s obligations according to the Royal College of Dental Surgeons of Ontario.
Accepted Dental Insurance Programs
At Atlas Dental, we work with the following dental insurance programs:
We do not accept the following public dental insurance programs
Accepted Payment Methods:
To facilitate payment at the time of service, Atlas Dental accepts multiple payment methods. Patients can conveniently settle their accounts using debit cards, Mastercard, and Visa. We also accept cash and e-transfer. Our goal is to provide you with flexibility and convenience when it comes to managing your dental care expenses.
Direct Billing Policy:
Atlas Dental does not accept the assignment of dental insurance benefits, commonly known as direct billing. What this means is that, at the time dental treatment is rendered, the patient is responsible for payment. This policy allows us to maintain our focus on delivering high-quality care without being constrained by the limitations of specific insurance networks.
Insurance Claim Assistance:
Although we do not offer direct billing, our dedicated team at Atlas Dental is here to assist you with the insurance claims process. We understand the importance of maximizing your insurance benefits, and we are committed to making the claims process as straightforward as possible for you.
Upon completion of your dental treatment, our office will provide you with all the necessary documentation and information needed to submit a claim to your dental insurance provider. We will guide you through the process and answer any questions you may have to ensure a smooth and efficient reimbursement experience.
Reimbursement Process:
Patients will receive payments directly from their insurance carrier. If direct deposit is set up with your bank account, electronic insurance reimbursement will typically take 24 to 48 hours. Alternatively, payments will be issued by cheque and sent via mail. This ensures that you receive your insurance reimbursement in a timely manner.
We believe that clear communication about our insurance policies helps foster a positive and trusting relationship with our patients. If you have any further questions regarding our insurance procedures, payment options, or if you require assistance with the claims process or want to know more about the dental services offered at Atlas Dental, please contact us.
Understanding The Terminology Of Your Dental Insurance Coverage
Understanding the details of your dental insurance is crucial to maximize its benefits and avoid unexpected costs. Here are some important things to know about your dental insurance:
- Alternative Benefit Provision: Some dental plans may offer alternative benefits if a covered service is not deemed appropriate or necessary. For example, your dental insurance may not cover the full amount for dental implant treatment, but may pay up to the equivalent amount for a dental bridge to go towards your dental implant. Understanding these provisions can be important for making informed decisions about your care.
- Claim Form: A Dental Claim Form is a standardized document used in the dental industry for the submission of dental services and expenses to insurance providers. This form is typically required if patients want to submit a claim to insurance themselves or for Coordination of benefits. Ask your dental clinic if you would like a dental claim form.
- Coinsurance and Copayments: Understand the cost-sharing arrangement. Coinsurance is the percentage of covered expenses you’re responsible for, while a copayment is a fixed amount you pay for a specific service.
- Coordination of Benefits (COB): In cases where an individual is covered by more than one dental insurance plan, coordination of benefits determines how the plans work together to cover the costs, ensuring there is no overpayment.
- Coverage Period (Start and End Dates): Determine the start and end dates of your dental insurance coverage. This is typically an annual period, and benefits may not roll over from one year to the next.
- Dependent Coverage: The inclusion of family members, such as spouses and children, under the dental insurance plan. Plans may have different premium structures and coverage options for dependents.
- Exclusions and Limitations: Review the list of exclusions and limitations in your dental insurance policy. Certain services or conditions may not be covered, so it’s essential to be aware of any restrictions.
- Maximum Benefit Amount: Know the maximum amount your dental insurance will pay for covered services during the coverage period. Once you reach this limit, you will be responsible for any additional costs.
- Preauthorization Requirements: Some dental procedures may require preauthorization from the insurance company before they are covered. Make sure to follow any preauthorization procedures outlined by your plan. Your dental clinic can help you submit a preauthorization request.
- Predetermination of Dental Insurance Benefits: This refers to a process in which a dentist or dental service provider seeks approval or confirmation from the insurance carrier regarding the coverage and benefits for a specific dental treatment or procedure before it is performed. This is often done to obtain clarity on how much the insurance plan will cover and what the patient’s financial responsibility will be.
- Types of Coverage: Familiarize yourself with the types of dental services covered by your insurance. Common categories include preventive, basic/restorative, and major procedures. Each category may have different coverage percentages.
- Waiting Periods: Be aware of any waiting periods for certain dental procedures. Some plans have waiting periods before they cover specific services, especially major procedures.
Being familiar with these terms can help individuals navigate the complexities of dental insurance and make informed decisions about their oral health care. We believe that clear communication about our insurance policies helps foster a positive and trusting relationship with our patients. If you have any further questions regarding our insurance procedures, payment options, or if you require assistance with the claims process or want to know more about the dental services offered at Atlas Dental, please contact us.
Leading Dental Insurance Companies in Canada
Atlas Dental works with numerous private dental insurance providers, each offering various plans with different coverage options. The availability of dental insurance plans and the types of coverage (individual, group, etc) may vary by region. For the most up-to-date and detailed information, individuals should directly contact insurance providers or consult their official websites. Here are some well-known dental insurance companies:
- Blue Cross Canada
- Canada Life (Formerly Great-West Life)
- Canada Protection Plan
- Desjardins Insurance
- Empire Life
- Green Shield Canada
- GroupHEALTH
- IA Financial Group (Industrial Alliance)
- Manulife Financial
- Medavie Blue Cross
- SSQ Insurance
- Sun Life Financial
- The Co-operators
We believe that clear communication about our insurance policies helps foster a positive and trusting relationship with our patients. If you have any further questions regarding our insurance procedures, payment options, or if you require assistance with the claims process or want to know more about the dental services offered at Atlas Dental, please contact us.
Claiming Dental Expense Tax Credit On Your Canadian Tax Return
Did you know that you can potentially claim back some money from out-of-pocket dental expenses on your T1 Personal Tax Return as a tax credit? Understanding what qualifies as eligible dental expenses, how to optimize the medical expense tax credit, and leveraging strategies to maximize your tax refund can make significant tax savings on household finances. Read our post on Claiming Dental Expense Tax Credit On Your Canadian Tax Return.
For more information regarding dental insurance, payment options, or if you require assistance with the claims process or want to know more about the dental services offered at Atlas Dental, please contact us.
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