Insurance and payment, made simple
We direct bill most major dental plans, so most of the time you'll only pay your share and we'll handle the paperwork. Here's how it works, what to bring along, and what your options look like if you don't have coverage.
Dental insurance is confusing, and that's not your fault. Every plan is a little different. Whatever yours looks like, you'll always know what something costs before we start, so nothing on your bill catches you off guard.
How direct billing works
- Tell us about your planBring your carrier name, policy or group number, and your member ID to your first visit. Covered under a spouse's or parent's plan? We'll need their details too.
- We send the claim for youAfter your appointment we submit everything electronically, usually the same day. No forms to fill out, nothing to mail.
- Your insurer pays us directlyMost carriers answer within minutes, so you'll usually know exactly where you stand before you head out the door.
- You cover the restThat's your co-payment, plus anything your plan doesn't include. If we're expecting that to be more than pocket change, you'll hear it from us beforehand, not after.
Plans we direct bill
These are the carriers we see most often around the Comox Valley:
- Pacific Blue Cross
- Canada Life
- Sun Life
- Manulife
- Green Shield Canada
- Desjardins Insurance
- Beneva
- Empire Life
- Equitable Life
- iA Financial Group
- ClaimSecure
- Chambers of Commerce Group
- Medavie Blue Cross
- Cowan Insurance Group
This isn't a complete list, so if you don't see yours, just call us at 250-338-2599 and we'll check it for you. It takes about a minute.
What to bring along
- Your carrier name, like Pacific Blue Cross
- Policy or group number
- Member, certificate, or ID number
- Plan holder's birthdate, if you're a dependent
- A list of any medications you take
- Previous X-rays or records, if you have them
No insurance? You're still welcome
Plenty of our patients pay out of pocket, and you're every bit as welcome here. We'll walk you through a clear written breakdown before we start anything, so you can decide what to go ahead with and when. We don't offer payment plans or financing, so treatment is paid for at the time of your visit. And honestly, regular cleanings and check-ups cost far less than fixing what goes wrong without them.
Planning something bigger?
For anything past a routine exam or cleaning, we can write up an estimate listing each procedure code and fee. Send it to your insurer and they'll confirm in advance what they'll cover. It takes a couple of weeks, but when you're weighing a larger treatment plan, knowing the number first is worth the wait.
Paying your share
We take cash, debit, e-transfer, Visa, and Mastercard, and we're happy to email your receipt. If you have a health spending account through work, it usually covers dental too. Just ask at the front desk and we'll format your receipt so your plan administrator accepts it without a fuss.
Why "covered" rarely means all of it
Almost nobody reads their plan booklet cover to cover, and we don't blame you. Here are the four things that surprise people most:
- Annual maximum
- Most plans cap what they'll pay each year, often somewhere between $1,000 and $2,000. Once you hit it, the rest is yours until the year resets. If you've still got room near year end, it's usually worth using it before it disappears.
- Coverage percentage
- Plans pay different rates depending on the work. Cleanings and check-ups are often covered at 80 to 100 percent, fillings around 70 to 80 percent, and bigger work like crowns and bridges at 50 percent or less.
- Frequency limits
- Your plan might cover a cleaning every nine months rather than every six, or X-rays only once every couple of years. It's why two people with the very same carrier can end up with very different bills.
- Fee guides
- Plans reimburse against a fee guide, sometimes an older one or one from another province. Our own fees reflect the time, materials, and expertise a procedure takes, and for some treatments they sit above what your plan pays out. That's where a gap can turn up even on something your plan technically covers in full, so we'll always give you the number up front.
Your insurer always has the final say on your coverage. We're glad to help you make sense of your plan, we just can't promise what they'll pay.
Common questions
Do you direct bill my dental insurance?
Yes. We direct bill most major dental plans. We send the claim in for you electronically, and most of the time you'll only pay the part your plan doesn't cover. Just bring your plan details to your first visit and we'll set it up.
Which plans do you work with?
Most of the major Canadian carriers, including Pacific Blue Cross, Canada Life, Sun Life, Manulife, Green Shield, Desjardins, Beneva, Empire Life, Equitable Life, iA Financial Group, ClaimSecure, Chambers of Commerce Group, and Medavie Blue Cross. Don't see yours? Give us a call at 250-338-2599 and we'll check.
What if my plan won't let you bill them directly?
A few employer plans ask you to pay the office and claim it back yourself. If yours is one of them, we'll hand you a detailed receipt with every procedure code your insurer needs, so getting reimbursed is simple.
Will I know what something costs before you start?
Always. For anything past a routine exam or cleaning, we'll write up an estimate with the procedure codes and fees. You can send it to your insurer ahead of time and they'll confirm what they'll cover, so there's no guessing.
What if I don't have dental insurance?
You're every bit as welcome here, and plenty of our patients pay out of pocket. We'll give you a clear breakdown before we start anything so you can decide what to do and when. We don't offer payment plans or financing, so treatment is paid for at the time of your visit.
Why did my plan cover less than I expected?
Usually it's an annual maximum, a frequency limit, or a coverage percentage. A plan that pays 80 percent for a cleaning might only pay 50 percent for a crown. Bring us your plan details and we'll help you make sense of it.
What should I bring to my first appointment?
Your carrier name, policy or group number, and your member or certificate ID. If you're on a spouse's or parent's plan, bring their details too. A list of any medications you take is helpful as well.
Not sure what your plan covers?
Give us a call with your plan details and we'll walk you through it before you book a thing.