In order to provide the highest quality care on a sound basis, we have developed convenient payment options for you. Prior to proceeding with treatment, fees and financial arrangements will be discussed with you.
We will always attempt to bill directly your dental insurance. However, it is understood that the patient is ultimately responsible for fees associated with services rendered.
We expect that any balance not covered by the insurance company to be paid at the time of service.
We accept most insurance plans and payments by Visa, MasterCard, debit and cheques.
Here at Rainbow Falls Dental, our knowledgable and professional team are here to assist our patients with understanding and utilizing their dental insurance coverage. For your convienience, we will direct bill your insurance company for you whenever possible. When arriving at your appointment, it is very important that you bring you insurance information with you AND notify us of any changes in your policy.
Our office will accept direct payment from your dental plan for the cost of those dental services provided which are covered by your individual policy. However, not all services or amounts are covered. There are many variations of individualized treatment plans as well as insurance policies, making each one a little different from the next. With this in mind, it is almost impossible for us to know the details of individual policies off hand.
We are more than happy to submit your information to your insurance company for you. However, payment for dental services rendered is due at the time of service. We conveniently offer the following payment options:
A1: Your particular dental plan may or may not cover the full cost you incur for your necessary dental treatment. In other words, a percentage of the claim may not be covered by your dental plan (resulting in a “co-pay”). This can occur because fees in our office are based on factors and fee guides, which may or may not have been considered by your employer or policy when enrolling in your plan. In addition, there may be certain dental procedures performed or recommended by your dentist or dental hygienist which are not covered by your individual policy. Our recommendations and quality of care here at Rainbow Falls Dental are based on professional judgement and the best treatment possible for you, not on your insurance plan.
A2: We at Rainbow Falls Dental will strive to provide the most accurate estimate possible prior to starting treatment. In order to obtain this information, we will be happy to file a “pre-treatment estimation” also known as “pre-D” to your insurance company with your permission. It is important to keep in mind that there are many variations of insurance policies and plans, therefor it is almost impossible to know the details of your individual policy. In addition, what one person might pay “out of pocket for services” may vary from yours depending on a) necessary treatment and b) dental plan details.
A3: Many patients believe that the dentist can simply “waive” these amounts so the patient doesn't have to pay the remaining balance. For example, your insurance plan may only cover 80% of major treatment, resulting in the patient owing 20% of the treatment provided. The consequences to dentists for not making a reasonable attempt to collect the co-payment are very serious. Insurance companies reserve the right to make this a legal matter as well as request that the patient provide proof that the co-payment has been paid. If the patient is unable to provide that proof, the insurance company may demand the patient make financial restitution to the insurance company or it may apply the overpayment to future claims. Please be mindful of these situations. If you require financial assistance or payment plans, a member of our treatment coordination team would be more than happy to assist you.
A4: Each and every insurance plan is designed differently. Being familiar with your insurance plan can help you become more aware of your “out-of-pocket” expenses.
In addition, your dental benefit may vary for a number of reasons, such as:
- You have already used some or all of the benefits available from your dental insurance for that year
- Your insurance plan paid only a percentage of the fee charged by your dentist
- The treatment you needed was not a covered benefit
- There may be a deductible (individual or family), or you may have received treatment in another office prior to joining Rainbow Falls Dental which is not calculated into our database
- You have not reached the end of your plan’s waiting period and are currently ineligible for coverage
A5: An EOB can be a very valuable piece of information. Your explanation of benefits is a document you receive from Rainbow Falls Dental after you visit the dentist. It is not a bill, but rather an explanation of what procedures were performed and what was covered by your dental plan. Though EOBs vary across insurance companies, they should include i) the dentist's fee, ii) the portion paid by your insurance, and iii) any amount you may owe (such as deductible, coinsurance or non-covered services). It should also, but does not always, include an update on how much of your annual maximum has been used and the amount you've paid toward your deductible.
A6: No. It is very common for dental plans to limit or exclude coverage for some dental procedures, this does not mean that your doctor’s recommendation is not in your best interest for optimal oral health. Some plans, however, go on to exclude or discourage necessary dental treatment such as sealants, pre-existing conditions, adult orthodontics, specialist referrals and other dental needs. Some also exclude treatment by family members. Patients need to be aware of the exclusions and limitations in their dental plan but should not let those factors determine their treatment decisions. If you have questions regarding coverage by your plan or details on recommended treatment, our dentists are more than happy to review them with you. Insurance benefits amounts are not, and should never be, a guideline for quality of care.
A7: Generally, your program covers you. Your spouse's program covers him/her. You may have additional coverage from each other's programs if they cover spouses and dependents. In no case should the benefit derived from the two coordinated programs exceed 100 percent of the dentist's charges for treatment but usually will cover 100% of services rendered if coverage is available for both individuals. The primary plan for covering your children depends on the regulations of your policies. Most plans use the "birthday rule" (spouse with birthday occurring earlier in the calendar year is primary). Others consider the father's plan primary. If you have two or more potential sources of coverage, check the coordination of benefits language for each plan to determine the benefits available or contact a member of our treatment coordination team to review the details. It is very important that you bring both insurance policies with you AND notify us of any changes in your policy.
A8: Rainbow Falls does request payment in full for your portion at the time of service. Since each and every person’s situation is unique, it is best to contact us directly to discuss financial concerns you might have. By doing this we can help establish a treatment plan that addresses your dental needs while taking into consideration your financial planning.
Rainbow Falls Dental is located at Unit 214, 100 Rainbow Rd, Chestermere, AB T1X 0V2
and proudly serves the surrounding areas of Chestermere and East of Calgary