Using Dental Insurance at Westdale Dental
If you have dental insurance, we will help in every way we can to file your claim and handle insurance questions on your behalf. Here are the basic steps to the process:
- Provide us with the details of your insurance plan when making your appointment. Always bring your dental insurance card with you to your dental appointment.
- Know and understand your dental insurance policy. If you have any questions, consult your insurance company or employer for clarification.
- Assign your insurance benefit to Westdale Dental so we can file your claims on your behalf.
We will provide you with an estimate of your patient portion based on information you provide to us. Every insurance plan provides different levels of benefits based on the coverage your employer has provided. We will ask for your estimated patient portion at the time of the appointment. For your convenience, we accept cash, check, debit card, CareCredit, or major credit card (Visa, MasterCard or Discover).
We will submit an insurance claim on your behalf following your appointment. It typically takes 3 to 6 weeks for the insurance companies to respond with payment.
Your insurance company typically sends you an Explanation of Benefit (“EOB”) that provides you all of the details on how they have processed the claim. Note that in some cases, they may not pay anything based on provisions in your contract.
Once we have received payment from your insurance company we will provide you with a statement summarizing any remaining balance that you are responsible to pay. In the event your insurance company denies payment for any reason, you will be responsible for all charges incurred for your care.
Dental Insurance Terminology
Deductible—The amount of money that you must pay to your dentist out-of-pocket before your insurance company will pay for any services. This amount is set by your employer when purchasing or setting up the plan as a benefit.
Explanation of Benefits (EOB)—This is a document prepared by the dental insurance company and issued to the patients and dentist. It explains how the insurance company has adjudicated the claim that was submitted for services provided to the patient.
Missing Tooth Clause—Protects the insurance company from paying for the replacement of a tooth that was missing before the policy was in effect.
Replacement Clause—Protects the insurance company from paying to replace dentures, partials, bridges, etc., until a specified time limit has passed.
Waiting Period—The length of time an insurance company will make you wait after you are covered before they will pay for certain procedures.
Yearly Maximum—The total amount that your insurance company will pay for any services during the plan year. The yearly maximum renews every year, typically on January 1, but your employer may have set a different date.