Insurance and payments
Understanding how estimates, insurance, preauthorizations and patient responsibility work.
Understanding the role of insurance
Dental insurance is an agreement between the patient and their insurer. We can help you transmit certain information or estimates, but final confirmation of coverage, limits and balances remains the patient's responsibility.
Estimates
- →An estimate is not a guarantee of payment
- →The insurer's response may vary
- →Deductibles, annual maximums, exclusions and frequencies may affect reimbursement
- →Any uncovered balance remains payable by the patient
Private insurance
- →Transmission possible depending on available systems
- →Coordination with the front-desk team
- →Importance of providing accurate information
Federal program / Canadian Dental Care Plan
Some patients may be eligible for the Canadian Dental Care Plan (CDCP, formerly RCSD) based on the program's criteria.
Our team can help verify the administrative information available. Program rules may vary by treatment, coverage and required authorizations. We cannot guarantee in advance that a given clinical procedure will be covered.
RAMQ where applicable
Some dental services may be covered by RAMQ (Quebec's public health insurance) in specific contexts (for example certain care for children or recipients of last-resort financial assistance). Many dental treatments are, however, not covered by the public plan.
Direct payment or reimbursement
- →Payment by the patient followed by reimbursement
- →Electronic transmission possible depending on the insurer
- →Outstanding balance to be settled
- →Deposit or payment may be required depending on the treatment, where applicable
Preauthorizations
- →Useful for certain treatments
- →Not an absolute guarantee
- →May take time
- →May require radiographs, codes, treatment plans or justification
Appointment policy
- →Cancellation
- →Late arrival
- →Missed appointment
- →Missed-appointment fee where applicable
- →Respect for clinical time
The specific policies will be communicated at the time of booking or before the relevant treatments.
An administrative question?
Our team can help you coordinate with your insurer or clarify the terms of a treatment.