Trusted by Canadian Orthodontists
Orthodontic Insurance Verification for Canadian Clinics
Insurance calls, off your plate. Smilepass verifies ortho coverage, tracks pre-determinations for braces and aligners, and chases claims.
Platform
Built for the Way Orthodontic Plans Pay Out
Smilepass handles ortho insurance end-to-end: verification, estimates and claim follow-up, so every estimate comes back and more patients say yes to treatment.
Ortho Insurance Verification
Complete breakdown details on ortho coverage, verified in minutes:
Maximums (annual vs. lifetime)
Age restrictions
Lump-sum vs. monthly payments
Benefits used to date
Deductibles
“We stopped calling insurers entirely. Breakdowns that took hours now we get them in minutes!”
— Practice Owner, Toronto
Insurance Estimate (Pre-D) Tracking for Braces & Aligners
Every pre-determination followed up until the insurer responds, with the covered amount and patient portion ready to present, and synced to your PMS.
Pre-Ds that stall past the insurer’s turnaround are escalated to your dedicated insurance coordinator.
Ortho Claim Follow-up
Every outstanding claim tracked and chased at 30, 60 and 90 days, with denials flagged by reason and resubmitted, so nothing gets written off.
When a claim needs a phone call, your dedicated insurance coordinator makes it.
How it works
Orthodontic Insurance, Handled from Consult to Paid Claim
1 · Verify Before the Consult
Complete ortho breakdown: maximums, age limits, payment mode, benefits used, deductibles.
2 · Track Ortho Estimates (Pre-Auth)
Braces or aligners, chased until the insurer answers.
3 · Present the Case
Covered amount and patient portion ready at chairside.
4 · Follow Up the Claim
Claims chased at 30, 60 and 90 days, and denials resubmitted.
“Ever since we implemented Smilepass, we make far fewer insurance calls and spend more time with patients. It has significantly boosted our patient experience and our case acceptance.”
— Dr. David, Orthodontist
FAQ
Orthodontic Insurance Verification, Answered
What does orthodontic insurance verification include?
A complete ortho breakdown for each patient: the orthodontic coverage percentage, whether the maximum is annual or lifetime and how much of it has already been used, age limits, deductibles, and whether the plan pays monthly or in a lump sum. Every breakdown also records the date, the carrier representative’s name and the call reference number.
How does a lifetime orthodontic maximum work in Canada?
Most Canadian plans cap orthodontic coverage with a lifetime maximum per person rather than a yearly one, and anything already paid toward ortho, including treatment with a previous provider, counts against it. Many plans also limit ortho coverage to dependants under a set age. Smilepass checks the remaining lifetime balance and the age limit before the consult, so the estimate you present holds up.
Do you submit pre-determinations for aligners?
Your clinic submits the pre-determination, and Smilepass takes it from there. Pre-determinations for clear aligners such as Invisalign are followed up the same way as braces: we stay on the insurer until it responds, and the covered amount and patient portion come back ready to present and synced to your PMS. Any that stall past the insurer’s turnaround are escalated to your dedicated Insurance Coordinator.
How are denied orthodontic claims handled?
Every outstanding ortho claim is tracked and chased at 30, 60 and 90 days. Denials are flagged by reason and resubmitted, so nothing gets written off, and when a claim needs a phone call, your dedicated Insurance Coordinator makes it.