How does direct billing work?

Direct billing is processed for each dental appointment. Insurance information is verified for that visit, and a claim is submitted for the specific dental services provided. The insurer pays the portion covered by the plan, and the patient is responsible for any remaining balance. This keeps payments tied to the exact treatments received at each appointment and helps clarify what portion of each dental service is covered by insurance.

Does my insurance plan allow direct billing?

Direct billing availability can also vary between dental clinics. Some clinics are set up to submit claims electronically for most major insurers, while others may only support certain plans or require payment upfront for specific services. Because insurers set their own rules around assignment of benefits, and dental clinics choose which systems they use, confirming direct billing in advance is the best way to know whether your plan can be processed at your appointment.

Will there be any extra costs?

You may still be responsible for costs not covered by your insurance plan. This can include co-payments, deductibles, plan limits, or dental services that fall outside your coverage. Reviewing your plan details can help clarify what portion of a visit may lead to an out-of-pocket expense.

What information is required?

Most appointments only need basic insurance details, such as an insurance card or policy information. Some plans may also require an assignment-of-benefits form so the insurer can send payment directly. Any additional documentation depends on the requirements of the specific insurance plan.

Can all treatments use direct billing?

Most dental appointments only require basic insurance details, such as an insurance card or policy information, so the clinic can process claims for common dental procedures. Some plans may also need an assignment-of-benefits form to allow the insurer to send payment directly for eligible dental services. Any additional documentation depends on the requirements of the specific insurance plan.

Can I use direct billing with multiple plans?

Direct billing can be used when a patient has more than one insurance plan that includes dental coverage. One plan is processed first as the primary plan, and the second plan may cover part of the remaining eligible balance. However, combined payments cannot exceed the total cost of the dental treatment, and the secondary plan may not always pay the full difference.

What if my claim isn’t approved?

If a claim is declined or only partially approved, the remaining balance becomes the patient’s responsibility. This can happen when a dental service isn’t covered by the plan, when annual or frequency limits have been reached, or when the plan’s rules don’t allow further payment. The explanation of benefits from the insurer can help clarify why the claim wasn’t fully approved.

Is CDCP available with direct billing?

Canadian Dental Care Plan (CDCP) claims can be billed directly when a dental clinic is enrolled as a CDCP provider. A claim is submitted for each visit, and the covered amount is paid according to CDCP rules and fee schedules. Any portion not covered must be paid by the patient.

Find dental clinics with direct insurance billing near you.

Service availability by province

Alberta

British Columbia

Ontario

Quebec

Nova Scotia

Halifax, NS

Manitoba

Winnipeg, MB

Saskatchewan

New Brunswick

Fredericton, NB

Prince Edward Island

Cornwall, PEI

About Direct Billing

Direct billing allows dental clinics to submit insurance claims on behalf of patients, so there’s no need to handle the paperwork or pay the full amount upfront. The insurer pays its covered portion directly to the clinic, and the patient pays only the remaining balance based on their plan.

This process helps simplify payment, reduce upfront costs, and make dental visits more convenient.

Direct Billing FAQs

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