Canada Insurance Plans

The Insurance Plan looks slightly different in Canada than it does for other countries. The key difference is terminology; all insurance plan fields are in the same place.The screenshot below shows how the window looks for Canadian offices.

Assignment of Benefits (pay dentist): When checked, insurance will send payments to provider. When unchecked, payments will be sent to patient. Unchecking box will also turn off the automatic import of EOBs (when in use in Clearinghouses).

Benefit Information: To see recommended insurance categories for Canada, see Canada Insurance Categories.

Scroll to the bottom of the Insurance Plan Information section on the left and there will be a Canadian section.

Dentaide Card Sequence: Enter the mandatory two digit value for Dentaide.

Plan Flag: Usually left blank, but used to indicate one of three kinds of Provincial Medical Plans:

Is Provincial Medical Plan: If Plan Flag indicates a Provincial Medical Plan, check the box. If it is blank, uncheck the box.

Diagnostic and Institution codes: Only required if Plan Flag is set to A.

Request Electronic Benefits

To request electronic benefit information from the insurance carrier, click Request in the middle of the window. The request will be sent to the clearinghouse that is set as the default and you will receive a printout response. There will also be a row in the claim history with a short note indicating if the patient is eligible or not.