Questions about Insurance? Read This First!

What does it mean to Direct Bill insurance? Are you able to Direct Bill my plan?

There are two ways that a dental office can process insurance. The first way is for you to pay the whole cost of treatment at the time of your visit, and be reimbursed by your insurance later on. The second way, direct billing, means that we estimate what your insurance will cover, and collect the non-covered portion from you at the time of your visit. We are able to direct bill to most Bow Valley insurance plans, including:

  • Fairmont Banff Springs and Chateau Lake Louise
  • Town of Banff
  • Parks Canada
  • Brewster
  • The Banff Centre
  • and many other local employers

How do I set up Direct Billing?

Please bring in your full insurance information including name, SIN, and date of birth of the insured person, employer, policy number, division number, and certificate number. If you have an insurance card, please bring it in. You will also need to have a credit card number left on file at our office to set your account balance to zero in case of an over or under-estimation of what your plan will cover.

How do I find out what is covered by my plan?

You are ultimately responsible for finding out what your plan does and does not cover. We realize this can be confusing for many people and we will do our best to help. A good start is to read any documentation given to you about your plan by your employer. You can also bring the documents to us if you don't understand them.

If you have questions, find out who your benefits administrator is and use our Insurance Info form as a guideline to get information from him or her directly. The answers to the questions on the form will help us estimate your coverage.

We often try to get a cost estimate (or "predetermination") for any treatment that is planned, although many insurance companies do not give us the requested information about your coverage, due to privacy reasons. Instead, they may give the information to YOU (you may have to call or login online to get it) and you then have to pass it along to our office.

How do you set your fees? And why doesn't my insurance cover my whole bill?

The cost of dental treatment can vary between offices, and depends on a number of factors. At Banff Dental Care, we set our fees based on various factors including complexity of care, overhead costs including sterilization, infection control, materials, laboratory fees, and other costs which tend to be higher in Banff such as rent and staff wages. There is a suggested fee guide published yearly in Alberta; we refer to the 2020 Fee Guide as well when setting our fees, though some fees fall below or above this guide and dentists do not have to follow it.

Just like each dental office has its own fee guide, each insurance company has its own fee guide listing what it will cover towards each procedure. Most of the time, the insurance fee guide is lower than what the dental office charges. Thus, "100% coverage" rarely covers 100% of the cost of treatment. Most patients have to pay the dental office a portion over and above the amount the insurance company's fee guide will cover. This is universal throughout all dental offices in Alberta.

I don't have insurance - What are my options for financing treatment?

Our office does not directly offer payment plans or financing for treatment. However, we are partnered with both Dentalcard and PayBright, companies that may be able to finance your treatment for you (you would then pay installments to the company instead of to our office). For more information, please talk to us in person.

Often we are able to find out whether you are approved for financing on the same day you come in! If you think you may want third-party financing, please bring in a blank cheque or a document from your bank which has your account, branch, and institution number on it so we can start the approval process.

As an alternative, people often have a friend or family member help them pay for their treatment. Our office will accept payment from another person, provided we have their consent. We have a Form for this that the person paying can fill out and sign to ensure that there will not be any problems processing payment when you come in for treatment.

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