Insurance Question Handout

Call us: New patients please call (226) 400-6276

Existing patients call (519) 442 4452 or toll-free 1 844 442 4452

Please have the following information ready when contacting your Insurance Company about your dental coverage:
Name*
First Last
Address*
Street Address City Postal Code
Date of Birth*
Phone Number*
Type of Phone Number*
- Home
- Cell
- Work
Email*
Preferred Method of Contact
- Phone
- Email
When Should We Contact You?*
Name of Insurance Company
Insurance Company Phone Number
Group/Policy Number
Certificate/ID Number
Please ask the following questions when speaking to your Insurance Company:
My insurance coverage based on
- Calendar Year
- Rolling Year
What is the maximum allowable amount per person?
Is there a co-payment?
- Yes
- No
Which year’s fee guide does my plan use?
The following treatment has been recommended, these are the codes used by Insurance Companies to determine eligibility