Dental Insurance & Financing

A) We follow the latest ADA&C Dental Fee Guide!

A) South Calgary Dental & Orthodontics offers the convenience of direct billing, as long as the policyholders Benefit Provider allows for this service. In some cases, we will not accept the assignment of benefits if there is a balance on account your account or a history of account issues. Also, there are some insurance policies that will not allow the benefits to be assigned to the dental office and will only forward their payment to the policy holder. In this case, we require payment for your dental services at the time of treatment

A) We are unable to know exactly what your dental benefits will pay. However, we will do our best to provide you with an estimated patient portion. It is the responsibility of the patient to know the details of their insurance plan and to inform us when changes occur to the plan, what is covered by the policy and who is covered under the policy.

Due to privacy laws, we are not permitted to access any information on your behalf from your insurance provider. If you have your plan details, please bring them along to your appointment.

A) An estimate for your treatment is based on the most recent information that we have on file. If you’re concerned about exactly what costs you’ll be responsible for, simply ask about our ‘Pre-Determination.’

A) A Pre-Determination provides you with the exact cost of the treatment. Upon request, we will submit this information to your insurance provider before completing any treatment. While this may delay your treatment, you will know exactly what [if any) out-of-pocket costs you may be required to pay.

A) We require payment in full for your patient portion at the time of treatment. We accept MasterCard, Visa, American Express, Financing and Interac (Debit).

A) We’re happy to put together a detailed treatment plan with the associated costs clearly outlined so that you can budget for each appointment accordingly. We can also prioritize treatments so that you can attend to the most urgent treatments right away and then plan further treatments over time.

A) No. Every dentist in Alberta is required to set their own fee guide based on their education and training, skill, clinical judgment and experience while taking into account the practice overhead costs. Each Benefit Provider also sets their own fee guide, often having many different fee guides for their different policies. This is why it is difficult for us to give our patients the exact amount which will be their portion outside of what their benefits will pay. Some plans pay below our fee guide; some pay the same fees, and some would pay fees higher than our fee guide.

A) We hear this question often. Usually, the patient has looked at his EOB [explanation of benefits statement) which tells you what the provider paid, or they check their plan booklet and sees that the fee charged by the dentist exceeds the fee guide amount set by the Benefit Provider. The problem is that the fee covered by the provider is whatever has been negotiated between your employer and the Benefit Provider, and is directly dependent upon the premium paid for your specific benefit policy. That is why the coverage can vary even between the employees of the same company or other patients covered by the same Benefit Provider.