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Direct billing to insurance in dental care

There are a lot of questions regarding insurance and dental care. If you are having an emergency dental situation and need emergency dental services, you can use this as a guide to understand how insurance and direct billing can come in handy when you need it.

Having to pay for your dental bill up front is not something that most people would be willing to do or very happy about. Many people that cannot pay upfront suffer the risk of not being able to care for their dental health. Your mouth health is important and it is important for your local dental clinic in Calgary SE to be direct billing. Be sure you call ahead to see if your insurance can be directly billed by the clinic.

The total amount owed on a dental bill can be a scary thing that can deter patients from getting the care they need and even if you do carry insurance, having to pay up front and out of pocket can be a headache. Putting off treatment can cause bigger issues to your mouth health in the long run. Direct billing also allows you to save time and effort so you do not need to fill out the forms, scan and present the receipt for repayment. Your repayment may take some time to reimburse you.

Many dental clinics understand this now and have made it a priority to offer direct billing to their clients.

How does direct billing work?

  • Your insurance provider and your dental clinic will have priorly connected to ensure they have the ability to direct bill them when you go in for a visit.
  • While you are visiting your dentist, the clinic will provide your insurance company with a dental claim for the total cost of dental treatment provided to you on the day of your visit.
  • After you are submitted for direct billing, you may have to pay a remainder that is owed for your visit. Your insurance may cover some, most or all of your visit… For example: Your bill could be $200 and if your insurance covers 70% of your visit, you would end up owing your dentist office $60 out of pocket. Be sure you consult with your insurance company beforehand so you know what to expect when you go in for treatment.

There are some risks to be aware of when working with your insurance provider with direct billing.

  • Not all claims are the same. Sometimes, insurance companies do not approve every claim and if a dental office does not receive the money from the claim, it will fall on the patient to pay. The problem with this is that dental clinics will not often know this until after the patient has left. The best way to mitigate this is to ensure that you have your dentist contact the insurance company beforehand for them to pre-approve the claim.
  • There can be a billing delay. Sometimes dentists will not receive reimbursement for the bill submitted to the insurance company for over a month, which could cause financial issues for the clinic. If this is the case, your dental provider may no longer work with that provider so ensure your dentist commonly works with the provider before your visit.

Direct billing is really a big blessing to save you tons of time, hassle and make your visits easy. Use this as a guide next time you go see your dentist and everything should go smoothly.

Direct billing is amazing for keeping your mouth healthy and your wallet happy.

Questions? Let's get in touch. 

Gurshant

Medically reviewed by Dr. Gurshant Grewal - a Registered Dentist on July 26, 2021

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