We have some fantastic news for those looking to have their dental care provider direct bill to their insurance company.
😆 White Summit Dental Hygiene now provides direct billing to insurance carriers! 😆
While we have supported eclaims for a few months now, since that time we’ve had many requests from patients to provide a direct billing service (also called assignment, or assignment of benefits) when eclaims is not available through their insurance provider.
The direct billing option is available to most patients. Read the following questions and answers put together for your enjoyment on this topic:
Q1: What does this mean for me as an existing patient?
Well first off, we love that you’re an existing patient!! Thank you! What this means for our existing patients is that they will be able to take advantage of us billing their insurance company directly. It means less-out-of-pocket expense, however you will still be responsible for the remainder owing on the account once your insurance provider has paid us.
Q2: How can I take advantage of this if I’m a new patient?
Thanks for asking!! First off, we would recommend that you book a complimentary consult with us. During this meeting we’ll be able to start all the necessary paper work, and you’ll also be able to meet our fantastic team! Here are the items you’ll need to bring to your first complimentary consult:
Your insurance benefits card. – This will have your plan group & ID info on it
Your insurance booklet. – This will contain coverage details of your plan. If you don’t have one, request one from your provider before your visit.
Photo ID – Yes, insurance fraud happens , and we’re committed to doing our part to prevent it. Please bring a drivers license, passport or other government issued photo ID.
Recent Pay stub/Recent Insurance statement – This helps us verify that your insurance is currently active.
Q3: Why do you require all of the background info?
When we offer this type of service, we are effectively extending you a line of credit for the amount of the procedure. Asking for the information indicated above helps us make the insurance claim process as smooth as possible for you, reduces the cases of insurance fraud, and also reduces the risk of extended credit to you without having to do a complicated credit check. If you have any further questions, please feel free to contact us!
Q4: How soon can I take advantage of Direct Insurance Billing?
If you’re an existing patient, and assuming we have your insurance info on file, you can use this service for your next visit! If you’re new to our clinic, your first appointment is typically a free consult, then for your next appointment, payment is expected upfront. Then every following appointment you can take advantage of our direct billing option! If you have questions, feel free to contact us.
Q5: What happens when my insurance provider doesn’t cover all of the treatment?
When you decide to have treatment at our clinic, you are responsible for covering the fees in entirety. In most cases insurance providers, will not cover all fees associated with treatment. In those cases you may make a personal visit to pay by cash, Debit, Visa, MasterCard or American Express. Alternatively you can take advantage of our online ePay service through Paypal, and settle your account from wherever you are in the world!
Q6: When would I not want to take advantage of this program?
Some insurance carriers, like Great West Life, have online claims processes for their patients. In these cases it’s typically easier for patients to pay up-front for dental fees and then complete the online claim form at Great West the same day. Great West has a good reputation for quickly paying out claims using this service. It saves everyone time, and some trees since we don’t need to send out a paper statement indicating payment is due on your account.
Q7: Are there cases where patients can NOT take advantage of direct billing?
Some insurance providers do not accept “assignment” or direct billing claims. In these cases we must request payment of fees on the same day as treatment. For this reason it’s important to understand your insurance program. We can also help patients understand their insurance programs during the complimentary consult.
In cases where patients can not satisfactorily provide the requested insurance and background information, White Summit Dental Hygiene may choose to not offer direct billing services. In these cases payment of fees are also expected on the same day as treatment.
Q8: Why does my insurance carrier not cover all fees associated with my care?
This is a loaded question, but basically it boils down to how well the business model for running an insurance company matches the business model associated with running a dental practice. The plain truth is that they just don’t line up. Generally, the more you or your employer pays in insurance premiums, the better the dental coverage is, however this is not always the case. The costs of running a dental practice are extraordinarily high. Although we feel we are very fair in our fee structure, there is still usually a gap in insurance coverage and dental fees.
If you are a business owner and you’re looking for options for preventive coverage for your employees, please contact us. We’re always interesting in working with insurance companies, and/or directly with the business community to meet dental needs.
For clients who have dental insurance, most are interested in how quickly they’ll receive reimbursements from their insurance carrier. Some insurance providers, such as Great West Life, have made this process easier by creating a website where their clients can submit their own claims thereby accelerating this process.
At White Summit Dental Hygiene we’re interested in helping our clients submit claims in a timely manner. Most claims today are printed, signed by all parties and are then mailed to the insurance carrier. We tend to take care of the mailing as part of our customer service to our clients.
Recently, however there have been developments in the area of eclaims for dental hygiene practices! The Canadian Dental Hygienist Association, has developed CDHA-ACHDnet, an electronic network capable of submitting claims to insurance carriers. White Summit Dental Hygiene has enrolled in this program and have started submitting claims directly to providers. Today, the providers on the network is limited to:
Alberta Dental Services Corporation
If you have coverage at the above providers, we can submit eclaims directly for you today! If you have a carrier other than the ones listed above, but would like eclaims service with them, feel free to contact your provider and ask them to start supporting CDHA-ACHDnet.