What Every Insured Patient Needs To Know

Ø  The name of the insurance carrier and the telephone number.

Ø  The name of the person in your company who is in charge of employee benefits.

Regarding the Policy:

Ø  What is the anniversary date of the policy?

Ø  Is there an annual deductible? If yes, how much is it?

Ø  What is the annual maximum allowed per patient?

Ø  Dental benefits are paid on which year’s Ontario Dental Association fee schedule?

Ø  How many units of scaling and/or root planning are covered per year?

Ø  Which codes are allowed for these services?

Ø  How many Recall appointments are allowed annually? Eg. every 3,6, or 9 months.

Ø  What percentage of coverage is allowed for the following:

o   Diagnostic services

o   Preventive services

o   Restorative services

o   Endodontic services

o   Periodontal services

o   Major Treatment eg. crowns, bridges, dentures

Ø  What is the annual maximum for major treatment?

Ø  Is Endodontic and/or Periodontal treatment classified as basic or major treatment?

The following information is required when patients call their insurance company.

Ø  Name of subscriber.

Ø  Employee’s date of birth.

Ø  SIN number.

Ø  Employer.

Ø  Policy number.

Ø  Division number.

Ø  Certificate number.

 

589 South Pelham Road, Welland, ON L3C 3C7 ~ Phone: 905-735-3362

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©2007 South Pelham Dental ~ James Takacs, DDS ~ Lily Marchinko, DDS ~ Caila Bruzzese, DDS