How can I pay for orthodontic treatment?

Orthodontic fees are personalized according to the treatment required. All fees are broken down into an initial payment and monthly payments made over the time of treatment. There is no interest charged or GST payable on orthodontic treatment. We accept Visa, Mastercard, Interac, auto-debit and post-dated cheques. We will not accept payments directly from an insurance company.

How does orthodontic insurance work?

Your insurance policy is an agreement between yourself and your insurance company. There is usually a lifetime maximum per person. How you decide to finance your orthodontic treatment is your decision and does not affect how your insurance company will reimburse you. Most insurance companies will only reimburse you for services rendered as they occur. In orthodontics this means up to one third of the total cost when treatment starts and each following month an equal portion of the remainder for the estimated duration of treatment until the maximum has been reached. 

Do I need to submit a pre-authorization?

All insurance companies require a pre-authorization for orthodontic treatment before they will accept claims. 

My insurance company says I need procedure codes.

There is an agreement in place between Certified Specialists in Orthodontics in Canada and the insurance associations that procedure codes are not required for orthodontic treatment. 

How do I claim fees from my insurance company?

In our office you will receive claim forms to cover the entire treatment period. It is your responsibility to make your claims according to your insurance policy requirements. Most insurance companies will not accept receipts for payment and they often have time limits for submitting claims. 

How do we claim if I have coverage with more than one insurance company?

You need to send pre-authorizations to both companies. When claiming for a child, each month, the parent with the birthday that falls first in the year, would claim first, and then send the remainder to the second or third company along with a copy of the explanation of benefits. You cannot claim more than 100% of what you pay. 

Will you submit my claims electronically?

We will not submit your claim forms for you as we have no relationship with your insurance company and unfortunately, there is no system for us to claim orthodontic payments electronically. 

What if I pay for treatment in full?

We would be prepared to give you a 5% administration discount for paying in full. However, your insurance company would still reimburse you over the time of the treatment. 

I have run out of claim forms, what should I do?

Check to see if you have reached your maximum lifetime limit on your last payment from your insurance company. If not, please call our financial coordinator to discuss this.  

We have new insurance coverage, what should I do?

If the new coverage is with the same employer, check with the human resources department to see whether you need a new pre-authorization. If you or your spouse has brand new coverage, you will need to call us to receive a new pre-authorization. You would then receive a confirmation from the new company as to the coverage that is still available if the patient is mid-treatment. 

I have a Health Spending Account, is this the same as insurance?

Health spending accounts are not the same as insurance. They do not require pre-authorizations or claim forms but will accept receipts for reimbursement. Your payments do not have to correspond with treatment rendered with a Health Spending Account.  

Is orthodontic treatment tax deductible?

Any portion of the fee that is not reimbursed can be claimed as a medical expense.