Insurance Claims
What is Dental Insurance?
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Dental Insurance is a contract between you, your employer and your dental insurance company. The benefits you receive are based on the terms of the contract that was negotiated between your employer and the dental insurance company and NOT your dental office.
That is why some services might not be covered under your policy. The selection of non-covered services is not based on your specific dental needs, but rather strictly based on the contract agreed upon with the insurance company.
In addition, dental insurance plans have dollar amount limitation per year and dental insurance companies rarely cover 100 percent of any dental fee and, in many cases, cover 50 percent or even nothing at all of certain services that could be essential to your dental health.
Your Dental Insurance
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Dental insurance is a highly complex benefit that creates confusion for many dental patients. The complexities of dental insurance and the lack of sufficient information provided by some insurance companies make it very difficult for some patients to properly understand their benefits. Even more confusing is understanding how to properly work with your dental insurance company to achieve the highest level of benefits to which you are entitled.
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Ontario Fee Guide
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Saban Dental Office office charges fees for services rendered according to the Ontario Dental Association (ODA) current fee guide. This fee guide is adjusted annually by ODA.
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In order to assure fair business practices for all members as well as the Insurers, our regulatory body insists that all dentist licensed in the province of Ontario have obligation to charge for services rendered at least the amount as suggested in the current fee guide. Dentists are free to charge more, but charging less would be a cause for disciplinary action against the dental practice.
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Saban Dental Office has internal policy not to charge over the suggested ODA fee guide. Even if procedure turns out to be more complicated than initially anticipated, or it takes more time, we will not charge anything extra. That way all of our patients can have a peace of mind that they will never over-pay for the services rendered in our office.
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Covered and Non-covered Services
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Regardless of whether or not you have dental insurance or if the insurance in question is covering for the specific procedures or not, Saban Dental Office patients are subject to the same fees. Although we would alter treatment according to your specific needs, we do not alter our treatment or fees based on the insurance coverage.
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Assistance with Dental Insurance Claims
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Our office will do everything possible to help you understand and make the most of your dental insurance benefits. We will submit the claims electronically directly to your Insurer in order to achieve the maximum reimbursement to which you are entitled as quickly as possible.
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Procedures not covered or partially covered by your insurance company
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Patients need to understand that they are responsible for all fees not covered by their insurance company.
In order to comply with the rules of Royal College of Dental Surgeons, all dental clinics must make an effort to collect the full amount charged for the services rendered or be subject to disciplinary action, even suspension of their licence to practice dentistry. The purpose of this rule is to protect public and make sure that all patients are treated the same, while all service providers engage in the honest business practice and attract clients based on the quality service and not “dumping price”.
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Patients with no dental insurance
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Saban Dental Office provides certain flexibility for patients without insurance and might be able to assist in referring to financial institution that can finance your major dental work. Please call us directly and book a consultation to find out more.
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