Most Oral Surgery is classified as a “Surgical or Medical” problem and is often covered by medical health insurance. You do not need separate dental cover.
While I am familiar with most insurance companies and what they are likely to cover the exact nature of cover is determined by the policy you hold with your insurer. Therefore it is always wise to gain prior approval prior to any procedure so you know exactly what you are covered for, what your excess might be and what you are not covered for.
As a general guide, your initial consultation and any x-rays are usually covered by health insurance, once you have decided on treatment you then apply to your insurance company for prior approval. Usually to gain prior approval you will need a written estimate from me as well as a copy of my letter which I have written back to your referring dentist or doctor.
I am an affiliated provider for Southern Cross Healthcare, this means you do not need to do any paperwork as we do it all for you. We will process your prior approval and let you know whether your procedure is covered. Usually you will find out immediately if you are covered and what the short fall, if any, there may be.
I am also part of NIB’s first choice network which makes the insurance process easier.
If you have had treatment under General Anaesthetic then you will receive 2 invoices, one from your Anaesthetist, and one from Fernbrae Surgery. Wait until both arrive and send these to your insurer with a completed claim form. Also include any related costs to you, such as the initial consultation, x-rays and prescription medicine costs. Your insurer will pay the invoices directly.
It can seem daunting dealing with insurance companies. Our reception staff are familiar with the insurance claim process, if you have any questions then contact my friendly reception team. Each insurance company has a slightly different process but we can generally guide you through the process.
If you have had an injury which is registered with ACC then you will be elligible for assistance from ACC.
The costs of treatment are either fully funded or partially funded by ACC. As a general rule simple extractions and x-rays are partially funded while the surgical part of an implant is fully funded.
If you have been referred to me for implant treatment which is covered by ACC then I will firstly have to apply to ACC for prior approval. This is a complex process involving both your referring dentist and myself. We need to gather a lot of information, such as a 5 year dental history, consent forms, study models and x-rays, prior to sending off the application. This can take a wee while to get together. Then further time is needed for the claim to be processed by ACC.
One of the most important aspects of ACC is that complex treatment such as implants must be approved prior to treatment . If we do not gain prior approval the surgery will not be covered at all, even if you are eligible for cover.