Our surgeons and physicians at APEX Surgical are equipped to perform surgical treatment in the safest way possible.
Heightened COVID response safety measures include:
If you had an appointment that was canceled due to COVID19, we assure you that we will contact you to reschedule. Patients will be booked in order of cancellation. We appreciate your patience during these times. As always, your health, safety and exceptional surgical care are our top priority.Patient Registration
Here is a list of frequently asked questions about insurance:
Non-assignment means we do not direct bill to your insurance company. All fees associated with your appointment are paid for up front and your insurance provider will reimburse you directly. We will help you with your claim submissions and pre-authorizations, however, it is the patient's responsibility to know what is covered in their plan, including any limits to the plan or changes; and to attain reimbursement from their dental insurance plan provider.
If you have dental coverage and provide us with your insurance information, we can often send a predetermination to your insurance company to find out how much of your proposed treatment plan will be covered. The particulars of your treatment plan will not be confirmed until you have had your initial consultation. Sometimes we receive an immediate electronic response from your insurance provider when we submit a claim or predetermination on your behalf; if this is not the case, you will receive a response via mail or email from your provider. *We do not need a copy of this predetermination. It is for your records*.
As we are non-assignment and do not direct bill to your insurance, they will not release that information to us. You should be able to access this information if you are registered online with your insurance company or receive a notice of “Predetermination / Explanation of Benefit Coverage” via mail or email. Some insurance companies also have mobile applications that can be downloaded to access your coverage information from your cellphone.
Your own dental benefit coverage is your primary insurance provider and your partner’s is your secondary. There’s an exception if you are covered by First Nations Health Authority and either yourself or your spouse have private coverage; in this case the private insurance will be your primary ahead of FNHA.
Whoever's birth month comes first in the year is the primary insurance holder. If you happen to both be born on the same day of the month, it will default to whichever parent is older. If your dependents is covered by Healthy Kids or Ministry, this will be their primary insurance ahead of any benefits the parent(s) have.
If we have sent a predetermination on your behalf and you have since used your dental coverage at your dental office or elsewhere, the amount of your reimbursement for your appointment with Apex can/will change. We do not have access to your coverage, or to your benefit plan to inquire about any usage. You are responsible for following up with your insurance company if you wish to confirm your reimbursement amount before your appointment.
Your secondary benefit coverage will only reimburse you once they confirm the amount that the primary insurance has covered. This is often completed electronically, but you may need to wait until you receive a response from your primary insurance regarding your reimbursement before you can submit to your secondary insurance. We will provide you with the claim submission and/or predetermination form(s) to be mailed to your secondary provider and will let you know if you will need to include an “Explanation of Benefits” (your primary providers response on reimbursement amount).
We do not have any access to your benefit coverage information other than submitting the claim on your behalf. The details of a patient’s plan are protected by the Personal Information Protection Act (PIPA). Please follow up with your insurance provider for specific questions and details regarding your reimbursement.
When your claim is submitted by Apex Surgical, it includes all procedure codes, fees and corresponding tooth numbers required by the insurance company for your reimbursement. If you receive notice in the mail from your benefit provider requesting more information, please call Apex and we will do our best to assist you.
If you were unable to provide your dental insurance information to us at the time of your consultation or surgery, we can often submit the claim to your provider on your behalf if it is within 60 days from the date of service (your appointment date). This is not always the case depending on who you are insured with, but Apex Surgical will do our best to support you with your claim.
Apex Surgical is limited to sending a preauthorization or a claim to your primary insurance on your behalf. As there are many different insurance companies and different plans within those companies, we cannot always answer your questions. The best resource for your insurance question is your insurance company, they know your coverage best.
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