Question: Do I need to submit a pre-authorization?

All insurance companies require a pre-authorization for orthodontic treatment before they will accept claims. My insurance company says I need procedure codes. There is an agreement in place between Specialists in Orthodontics in Canada and the insurance associations that procedure codes are not required for orthodontic treatment.

Once you have established that you have orthodontic coverage, and after financial arrangements have been made with the orthodontic specialist, it is the obligation of the orthodontic office to provide you with a Canadian Association of Orthodontists Certified Specialist in Orthodontics Standard Information Form. Send this form immediately to the insurance company. The carrier will write to you directly about your coverage. When you make a payment to the orthodontic office, you will be provided with a receipt. Attach this to one of your Dental Claim Forms (filled in by the subscriber) and submit both to your insurance company who will re-imburse you directly.