Ortho Insurance

Orthodontic Insurance

How to Submit Your Insurance Claims

Orthodontic insurance claims are handled differently than the general dentistry claims that you may be used to. They are, however, all handled the same way no matter which carrier you may have at your place of employment. The exact amount of benefit does vary depending upon your contract.

Our staff will provide you with a pre-determination form. This form must be sent to your insurance company in order for them to approve your coverage and arrange to reimburse you. Fill in the information on the top right hand corner of the form. Keep the yellow copy for your records and return the white copy to your place of employment or directly to the insurance company.

This is the only form that requires Dr. Hurd's signature for the duration of orthodontic treatment.

Henceforth, our office will issue receipts for every payment made. You may also print your own receipts directly from our web site once you have registered your e-mail address and password with us. When you receive a receipt from us, send this receipt along with your SIN number, group number and certificate number to the insurance company. Most insurance companies prefer if you send this information on one of their standard dental claim forms. Attach the receipt from us to this form and then mail to your insurance company.

Upon receiving these receipts, the insurance company will then forward a cheque directly to you for their portion of the payment. It also helps to write: "ATTENTION: ORTHODONTIC CLAIMS" on the envelope.

AT THE PRESENT TIME, ELECTRONIC CLAIM FILING IS NOT AVAILABLE FOR ORTHODONTIC CLAIMS.

What Do I Do if Both Parents Have Insurance Coverage?

Step 1: When both parents have insurance coverage, it is necessary to send a pre-determination form to both insurance companies.

Step 2: After you send in the pre-determination forms, the insurance companies will send you a letter confirming your benefit. The insurance company of the person whose birthday falls first within a calendar year will pay any claims first, followed by the insurance company of the second person.

Example: Mom's birthday is April 7th (send this claim first). Dad's birthday is Oct. 11 (after receiving payment from mom's company then send to this company.) When you pay your bill at our office, please ask for two receipts (one for each insurance company). We can print as many receipts as you need, so don't worry if you misplace one.

Step 3: Mom must send in a receipt along with a standard form to her insurance company. When you receive payment from mom's insurance company, then you may submit the claim to dad's insurance company.

Step 4: Send a photocopy of the cheque received from the first insurance company along with the receipt from Dr. Hurd attached to a standard form to Dad's company. The second insurance company will then forward a cheque to you.

Helpful Hint: It is a good idea to photocopy all documents for reference. Remember to fill in the information on the claim form relating to dental benefits provided by another insurance company.