A registered dentist is classified as a ‘Provider’ of Dental Services.

A ‘Preferred Provider’ is a dentist who has a contractual agreement with a specific health insurer, whereby the dentist agrees to provide certain treatments to the health fund member, at an agreed maximum price. The agreed maximum price is normally lower than the Provider’s (Dentist) normal prices.  For treatments that are not covered under our no gaps policy, this means that your out-of-pocket expense will be lower.

No Gaps Dental clinics are Preferred Providers with the following health insurers;

• Medibank Member’s Choice locations: Beverly Hills, Bondi Junction and Blacktown
• BUPA Member’s First Platinum locations: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Cabramatta, Chatswood, Epping, Hornsby, Penrith and Sydney Haymarket
• Westfund Provider of Choice: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Brookvale, Cabramatta, Chatswood, Epping, Hornsby, Liverpool, Parramatta, Penrith, Randwick, Sydney Haymarket and Sydney Wynyard.

If you are covered for dental by Private Health Insurance, we need your health fund card before we can make a claim.  Similar to the way we can use digital credit cards from our phones, several health insurance companies have digitised their membership cards.  This means that rather than having your physical health fund card in your wallet, you can add your Digital Health Fund card to your AppleWallet or GooglePay and tap on our HICAPS terminal to make your health fund claim.

Not all health funds have digitised their membership cards.  A digital health fund card is currently* available with the following health funds:

*The above list is current as of May 2023.  Please check your health fund’s website for more information on when a digital card might become available.

How to get your Digital Health Fund Card

To get your Digital Health Fund card, you will need to

1. Download the latest version of your Health Fund’s app from the AppStore (for Apple users) or GooglePlay (for Android users) to your phone or Apple watch
2. Set up your membership in the App. To do this, you will need your membership number and a few other details to verify your identity
3. Once set up, you can add your digital membership card to wallet. Each health fund does it differently, so please refer to your health funds website for further instructions

How to use your Digital Health Fund Card

To use your Digital Health Fund card,

1. Open up your AppleWallet or GooglePay and select your health fund card
2. When the HICAPS terminal is ready, hold your device near the HICAPS terminal reader and wait for it to read your card (usually a beep will sound)
3. If you have multiple members on your card, click on the eclipse symbol (three dots) to see your ID, or check from within the app and inform the receptionist so that the claim is made against the correct person
4. The claim will proceed as normal

If your health fund doesn’t have a Digital Health Fund card yet

If your health fund has not yet digitised their membership cards, you will need to bring your physical health fund card to your appointment in order to make a claim.  Digital technology is rapidly changing, so in time, more health funds will digitise their health fund cards as well.  Please check your health funds website for more information on when a digital card might become available.

Understanding how much benefit your health insurer will pay towards your dental treatment gives you an idea of how much you may need to pay out-of-pocket.

To find out your remaining benefit limits, you can call your health fund and ask simply ask ‘How much benefit do I have remaining?’, or you may be able to find limited information via your health fund app on your smart phone.  Depending on which level of cover you are on, and which health fund you are with, your limits may be split between:

• General Dental (check ups and cleans),
• Preventative Dental (fillings and fissure sealants) and
• Major Dental (includes extractions, gum treatment, crowns, root canal treatment, implants)

For a specific quote / estimate on the benefit your health insurer will pay towards your treatment, you will need to provide them with the following information:

1. Your name and member number
2. The Provider Number
   1. This is a 6 digit number that identifies the dentist
3. Treatment ID / Item Number
   1. This is a 3 digit number, usually before the treatment description
4. Tooth ID / Number
   1. This is required for treatment specific to a tooth such as a filling, crown, root canal treatment or extraction
5. Treatment Price

The above information can be obtained from your treatment plan. Without a treatment plan or undertaking an examination, it is difficult to know what treatment you need, and the item numbers to provide to the health fund.

When obtaining a quote /  estimate from your health insurer, please note that if anything changes in relation to your policy, claims you have made to date or when your benefits expire, your quote / estimate will also change.

Due to privacy reasons, our staff are not able to speak to your health insurer without your authorisation to do so first.

To make a claim from your health insurer in our clinics,

1. Bring your current health fund card to your appointment
2. At the end of the treatment, our receptionist will swipe your card through the HICAPS terminal.
3. Details of your treatment will be sent directly to your health insurer and it will be processed instantly on the spot.

We accept most Australian health insurers and most can be processed via HICAPS.

If your health fund card is not working, or you’ve forgotten your card, we can provide you with an invoice and receipt showing what you have paid on the day of your appointment.  You can take these documents to your heath insurer to make the claim directly with them either online or at a branch.

Most health insurers also have an App available on your smartphone, and claims can be submitted electronically via the App by uploading a copy of the invoice and / or submitting specific information from the invoice.

There are a number of reasons why your health insurer may not pay a benefit for your dental treatment.  When we process the claim using our HICAPS terminal, a reason may be provided and we can provide you with information on how to resolve it with your health insurer.  Sometimes a reason will not be provided, and you will need to contact your health insurer.  We are not able to do this on your behalf as it is between you and your health fund.

When making claims via the HICAPS terminal, the most common reasons why your health insurer is not paying a benefit for your treatment includes;

There are over one thousand item numbers covering the different types of dental treatment.

We have summarised the most common item numbers below;

Health Insurers normally split dental treatment into two categories:

1. General Dental and
2. Major Dental

General Dental covers the basic level of dental treatments and normally includes; examinations, dental check-ups, clean and polish, simple extractions, fillings and x-rays.

Major Dental is a higher level of cover, and normally covers root canal treatment, treating gum disease, crowns, bridges, dentures and veneers.

Before claiming a benefit for major dental treatment, the health insurer will usually impose a “waiting period” of 2 or so months.

At a minimum, almost all health funds will pay a benefit for two dental check-ups per year, and with our ‘No Gaps Guarantee’ there will be no out-of-pocket cost for these procedures.

Our No Gaps Guarantee covers Simple Fillings, but what is a simple filling?

A tooth consists of 5 surfaces – the top, and four sides.  At No Gaps Dental, we categorise filling complexity by the number of surfaces that has decay and therefore need to be filled.

Here is a simple overview of our filling categorisation:

What am I covered for?
It’s a good idea to regularly review your health insurance cover to make sure it covers you for the treatment you need. To review your cover, please contact your health insurer directly.

We will provide you with a treatment plan and can run a quote (for most health funds), and we will obtain your consent before undertaking any treatment.

What does the No Gaps Guarantee cover?
Our No Gaps Guarantee means no out-of-pocket expenses for your dental check-ups, teeth scaling & cleaning, fluoride applications, x-rays and simple fillings.

Our No Gaps Guarantee does not apply to all types of treatment. This is due to the declining rebates from health insurers and the rising costs of operating our practices. To remain sustainable while maintaining our commitment to delivering quality care and value to our patients, some treatments incur an out-of-pocket fee. This allows us to maintain the high standards of care and service that our patients deserve.

If you have any questions, please do not hesitate to reach out to our team.

There are many different health funds that offer dental cover. Each fund have their own way of determining the benefit they will cover for your dental treatment.

Here are some factors you want to consider when selecting the right dental cover for you;

Per person limits
It is important to know the limits each person can claim for dental treatment each year. If you have a family policy, consider whether the limit is per person or one limit for the whole family.

Percentage versus fixed
Health funds either pay up to a fixed amount towards your dental treatment, or they will pay a fixed percentage of the treatment costs, up to a fixed amount.

Annual limits
Health funds will always specify the maximum benefits they will pay each year, per person or family.

Coverage
Depending on the type of policy, dental cover will normally be divided into General Dental and Major dental. Your policy will state whether you are covered for either or both, and will also state limits per person specified for each category.

With our ‘No Gaps Guarantee’ we will accept the benefit paid by your health insurer as full payment, provided no limits have been reached, for our preventative and restorative treatments, including examinations, scale & cleaning, fluoride, x-rays, sealants and simple fillings.

If you have health insurance and you are covered for dental, the cost of your dental treatment will be paid for in 2 parts:

1. The benefit amount that your health insurer will pay
2. The out-of-pocket amount that you will need to pay

Every health insurer has their own method to determine the benefit amount they will pay towards your dental treatment.

Health insurers will normally pay on your behalf either a fix amount, or a fixed percentage of the treatment costs up until your annual limit.  The level of benefit paid by your health insurer will also depend on the policy you have taken out (e.g. Bronze, Silver or Gold)

For treatments that are covered under our No Gaps Policy, as long as you have met the conditions under the policy, the cost of your dental treatment will be covered by your health insurance.  That means that there is no out-of-pocket amount to be paid by you. For all other treatments, there will be an out-of-pocket amount that you will need to pay for.

When your dentist provides you with a treatment plan, you can contact your health insurer and request a quote to see how much benefit they will pay towards your treatment.  This will give you an idea of how much out-of-pocket you will need to pay.

A registered dentist is classified as a ‘Provider’ of Dental Services.

A ‘Preferred Provider’ is a dentist who has a contractual agreement with a specific health insurer, whereby the dentist agrees to provide certain treatments to the health fund member, at an agreed maximum price. The agreed maximum price is normally lower than the Provider’s (Dentist) normal prices.  For treatments that are not covered under our no gaps policy, this means that your out-of-pocket expense will be lower.

No Gaps Dental clinics are Preferred Providers with the following health insurers;

• Medibank Member’s Choice locations: Beverly Hills, Bondi Junction and Blacktown
• BUPA Member’s First Platinum locations: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Cabramatta, Chatswood, Epping, Hornsby, Penrith and Sydney Haymarket
• Westfund Provider of Choice: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Brookvale, Cabramatta, Chatswood, Epping, Hornsby, Liverpool, Parramatta, Penrith, Randwick, Sydney Haymarket and Sydney Wynyard.

If you are covered for dental by Private Health Insurance, we need your health fund card before we can make a claim.  Similar to the way we can use digital credit cards from our phones, several health insurance companies have digitised their membership cards.  This means that rather than having your physical health fund card in your wallet, you can add your Digital Health Fund card to your AppleWallet or GooglePay and tap on our HICAPS terminal to make your health fund claim.

Not all health funds have digitised their membership cards.  A digital health fund card is currently* available with the following health funds:

*The above list is current as of May 2023.  Please check your health fund’s website for more information on when a digital card might become available.

How to get your Digital Health Fund Card

To get your Digital Health Fund card, you will need to

1. Download the latest version of your Health Fund’s app from the AppStore (for Apple users) or GooglePlay (for Android users) to your phone or Apple watch
2. Set up your membership in the App. To do this, you will need your membership number and a few other details to verify your identity
3. Once set up, you can add your digital membership card to wallet. Each health fund does it differently, so please refer to your health funds website for further instructions

How to use your Digital Health Fund Card

To use your Digital Health Fund card,

1. Open up your AppleWallet or GooglePay and select your health fund card
2. When the HICAPS terminal is ready, hold your device near the HICAPS terminal reader and wait for it to read your card (usually a beep will sound)
3. If you have multiple members on your card, click on the eclipse symbol (three dots) to see your ID, or check from within the app and inform the receptionist so that the claim is made against the correct person
4. The claim will proceed as normal

If your health fund doesn’t have a Digital Health Fund card yet

If your health fund has not yet digitised their membership cards, you will need to bring your physical health fund card to your appointment in order to make a claim.  Digital technology is rapidly changing, so in time, more health funds will digitise their health fund cards as well.  Please check your health funds website for more information on when a digital card might become available.

Understanding how much benefit your health insurer will pay towards your dental treatment gives you an idea of how much you may need to pay out-of-pocket.

To find out your remaining benefit limits, you can call your health fund and ask simply ask ‘How much benefit do I have remaining?’, or you may be able to find limited information via your health fund app on your smart phone.  Depending on which level of cover you are on, and which health fund you are with, your limits may be split between:

• General Dental (check ups and cleans),
• Preventative Dental (fillings and fissure sealants) and
• Major Dental (includes extractions, gum treatment, crowns, root canal treatment, implants)

For a specific quote / estimate on the benefit your health insurer will pay towards your treatment, you will need to provide them with the following information:

1. Your name and member number
2. The Provider Number
   1. This is a 6 digit number that identifies the dentist
3. Treatment ID / Item Number
   1. This is a 3 digit number, usually before the treatment description
4. Tooth ID / Number
   1. This is required for treatment specific to a tooth such as a filling, crown, root canal treatment or extraction
5. Treatment Price

The above information can be obtained from your treatment plan. Without a treatment plan or undertaking an examination, it is difficult to know what treatment you need, and the item numbers to provide to the health fund.

When obtaining a quote /  estimate from your health insurer, please note that if anything changes in relation to your policy, claims you have made to date or when your benefits expire, your quote / estimate will also change.

Due to privacy reasons, our staff are not able to speak to your health insurer without your authorisation to do so first.

To make a claim from your health insurer in our clinics,

1. Bring your current health fund card to your appointment
2. At the end of the treatment, our receptionist will swipe your card through the HICAPS terminal.
3. Details of your treatment will be sent directly to your health insurer and it will be processed instantly on the spot.

We accept most Australian health insurers and most can be processed via HICAPS.

If your health fund card is not working, or you’ve forgotten your card, we can provide you with an invoice and receipt showing what you have paid on the day of your appointment.  You can take these documents to your heath insurer to make the claim directly with them either online or at a branch.

Most health insurers also have an App available on your smartphone, and claims can be submitted electronically via the App by uploading a copy of the invoice and / or submitting specific information from the invoice.

There are a number of reasons why your health insurer may not pay a benefit for your dental treatment.  When we process the claim using our HICAPS terminal, a reason may be provided and we can provide you with information on how to resolve it with your health insurer.  Sometimes a reason will not be provided, and you will need to contact your health insurer.  We are not able to do this on your behalf as it is between you and your health fund.

When making claims via the HICAPS terminal, the most common reasons why your health insurer is not paying a benefit for your treatment includes;

There are over one thousand item numbers covering the different types of dental treatment.

We have summarised the most common item numbers below;

Health Insurers normally split dental treatment into two categories:

1. General Dental and
2. Major Dental

General Dental covers the basic level of dental treatments and normally includes; examinations, dental check-ups, clean and polish, simple extractions, fillings and x-rays.

Major Dental is a higher level of cover, and normally covers root canal treatment, treating gum disease, crowns, bridges, dentures and veneers.

Before claiming a benefit for major dental treatment, the health insurer will usually impose a “waiting period” of 2 or so months.

At a minimum, almost all health funds will pay a benefit for two dental check-ups per year, and with our ‘No Gaps Guarantee’ there will be no out-of-pocket cost for these procedures.

Our No Gaps Guarantee covers Simple Fillings, but what is a simple filling?

A tooth consists of 5 surfaces – the top, and four sides.  At No Gaps Dental, we categorise filling complexity by the number of surfaces that has decay and therefore need to be filled.

Here is a simple overview of our filling categorisation:

What am I covered for?
It’s a good idea to regularly review your health insurance cover to make sure it covers you for the treatment you need. To review your cover, please contact your health insurer directly.

We will provide you with a treatment plan and can run a quote (for most health funds), and we will obtain your consent before undertaking any treatment.

What does the No Gaps Guarantee cover?
Our No Gaps Guarantee means no out-of-pocket expenses for your dental check-ups, teeth scaling & cleaning, fluoride applications, x-rays and simple fillings.

Our No Gaps Guarantee does not apply to all types of treatment. This is due to the declining rebates from health insurers and the rising costs of operating our practices. To remain sustainable while maintaining our commitment to delivering quality care and value to our patients, some treatments incur an out-of-pocket fee. This allows us to maintain the high standards of care and service that our patients deserve.

If you have any questions, please do not hesitate to reach out to our team.

There are many different health funds that offer dental cover. Each fund have their own way of determining the benefit they will cover for your dental treatment.

Here are some factors you want to consider when selecting the right dental cover for you;

Per person limits
It is important to know the limits each person can claim for dental treatment each year. If you have a family policy, consider whether the limit is per person or one limit for the whole family.

Percentage versus fixed
Health funds either pay up to a fixed amount towards your dental treatment, or they will pay a fixed percentage of the treatment costs, up to a fixed amount.

Annual limits
Health funds will always specify the maximum benefits they will pay each year, per person or family.

Coverage
Depending on the type of policy, dental cover will normally be divided into General Dental and Major dental. Your policy will state whether you are covered for either or both, and will also state limits per person specified for each category.

With our ‘No Gaps Guarantee’ we will accept the benefit paid by your health insurer as full payment, provided no limits have been reached, for our preventative and restorative treatments, including examinations, scale & cleaning, fluoride, x-rays, sealants and simple fillings.

If you have health insurance and you are covered for dental, the cost of your dental treatment will be paid for in 2 parts:

1. The benefit amount that your health insurer will pay
2. The out-of-pocket amount that you will need to pay

Every health insurer has their own method to determine the benefit amount they will pay towards your dental treatment.

Health insurers will normally pay on your behalf either a fix amount, or a fixed percentage of the treatment costs up until your annual limit.  The level of benefit paid by your health insurer will also depend on the policy you have taken out (e.g. Bronze, Silver or Gold)

For treatments that are covered under our No Gaps Policy, as long as you have met the conditions under the policy, the cost of your dental treatment will be covered by your health insurance.  That means that there is no out-of-pocket amount to be paid by you. For all other treatments, there will be an out-of-pocket amount that you will need to pay for.

When your dentist provides you with a treatment plan, you can contact your health insurer and request a quote to see how much benefit they will pay towards your treatment.  This will give you an idea of how much out-of-pocket you will need to pay.

A registered dentist is classified as a ‘Provider’ of Dental Services.

A ‘Preferred Provider’ is a dentist who has a contractual agreement with a specific health insurer, whereby the dentist agrees to provide certain treatments to the health fund member, at an agreed maximum price. The agreed maximum price is normally lower than the Provider’s (Dentist) normal prices.  For treatments that are not covered under our no gaps policy, this means that your out-of-pocket expense will be lower.

No Gaps Dental clinics are Preferred Providers with the following health insurers;

• Medibank Member’s Choice locations: Beverly Hills, Bondi Junction and Blacktown
• BUPA Member’s First Platinum locations: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Cabramatta, Chatswood, Epping, Hornsby, Penrith and Sydney Haymarket
• Westfund Provider of Choice: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Brookvale, Cabramatta, Chatswood, Epping, Hornsby, Liverpool, Parramatta, Penrith, Randwick, Sydney Haymarket and Sydney Wynyard.

If you are covered for dental by Private Health Insurance, we need your health fund card before we can make a claim.  Similar to the way we can use digital credit cards from our phones, several health insurance companies have digitised their membership cards.  This means that rather than having your physical health fund card in your wallet, you can add your Digital Health Fund card to your AppleWallet or GooglePay and tap on our HICAPS terminal to make your health fund claim.

Not all health funds have digitised their membership cards.  A digital health fund card is currently* available with the following health funds:

*The above list is current as of May 2023.  Please check your health fund’s website for more information on when a digital card might become available.

How to get your Digital Health Fund Card

To get your Digital Health Fund card, you will need to

1. Download the latest version of your Health Fund’s app from the AppStore (for Apple users) or GooglePlay (for Android users) to your phone or Apple watch
2. Set up your membership in the App. To do this, you will need your membership number and a few other details to verify your identity
3. Once set up, you can add your digital membership card to wallet. Each health fund does it differently, so please refer to your health funds website for further instructions

How to use your Digital Health Fund Card

To use your Digital Health Fund card,

1. Open up your AppleWallet or GooglePay and select your health fund card
2. When the HICAPS terminal is ready, hold your device near the HICAPS terminal reader and wait for it to read your card (usually a beep will sound)
3. If you have multiple members on your card, click on the eclipse symbol (three dots) to see your ID, or check from within the app and inform the receptionist so that the claim is made against the correct person
4. The claim will proceed as normal

If your health fund doesn’t have a Digital Health Fund card yet

If your health fund has not yet digitised their membership cards, you will need to bring your physical health fund card to your appointment in order to make a claim.  Digital technology is rapidly changing, so in time, more health funds will digitise their health fund cards as well.  Please check your health funds website for more information on when a digital card might become available.

Understanding how much benefit your health insurer will pay towards your dental treatment gives you an idea of how much you may need to pay out-of-pocket.

To find out your remaining benefit limits, you can call your health fund and ask simply ask ‘How much benefit do I have remaining?’, or you may be able to find limited information via your health fund app on your smart phone.  Depending on which level of cover you are on, and which health fund you are with, your limits may be split between:

• General Dental (check ups and cleans),
• Preventative Dental (fillings and fissure sealants) and
• Major Dental (includes extractions, gum treatment, crowns, root canal treatment, implants)

For a specific quote / estimate on the benefit your health insurer will pay towards your treatment, you will need to provide them with the following information:

1. Your name and member number
2. The Provider Number
   1. This is a 6 digit number that identifies the dentist
3. Treatment ID / Item Number
   1. This is a 3 digit number, usually before the treatment description
4. Tooth ID / Number
   1. This is required for treatment specific to a tooth such as a filling, crown, root canal treatment or extraction
5. Treatment Price

The above information can be obtained from your treatment plan. Without a treatment plan or undertaking an examination, it is difficult to know what treatment you need, and the item numbers to provide to the health fund.

When obtaining a quote /  estimate from your health insurer, please note that if anything changes in relation to your policy, claims you have made to date or when your benefits expire, your quote / estimate will also change.

Due to privacy reasons, our staff are not able to speak to your health insurer without your authorisation to do so first.

To make a claim from your health insurer in our clinics,

1. Bring your current health fund card to your appointment
2. At the end of the treatment, our receptionist will swipe your card through the HICAPS terminal.
3. Details of your treatment will be sent directly to your health insurer and it will be processed instantly on the spot.

We accept most Australian health insurers and most can be processed via HICAPS.

If your health fund card is not working, or you’ve forgotten your card, we can provide you with an invoice and receipt showing what you have paid on the day of your appointment.  You can take these documents to your heath insurer to make the claim directly with them either online or at a branch.

Most health insurers also have an App available on your smartphone, and claims can be submitted electronically via the App by uploading a copy of the invoice and / or submitting specific information from the invoice.

There are a number of reasons why your health insurer may not pay a benefit for your dental treatment.  When we process the claim using our HICAPS terminal, a reason may be provided and we can provide you with information on how to resolve it with your health insurer.  Sometimes a reason will not be provided, and you will need to contact your health insurer.  We are not able to do this on your behalf as it is between you and your health fund.

When making claims via the HICAPS terminal, the most common reasons why your health insurer is not paying a benefit for your treatment includes;

There are over one thousand item numbers covering the different types of dental treatment.

We have summarised the most common item numbers below;

Health Insurers normally split dental treatment into two categories:

1. General Dental and
2. Major Dental

General Dental covers the basic level of dental treatments and normally includes; examinations, dental check-ups, clean and polish, simple extractions, fillings and x-rays.

Major Dental is a higher level of cover, and normally covers root canal treatment, treating gum disease, crowns, bridges, dentures and veneers.

Before claiming a benefit for major dental treatment, the health insurer will usually impose a “waiting period” of 2 or so months.

At a minimum, almost all health funds will pay a benefit for two dental check-ups per year, and with our ‘No Gaps Guarantee’ there will be no out-of-pocket cost for these procedures.

Our No Gaps Guarantee covers Simple Fillings, but what is a simple filling?

A tooth consists of 5 surfaces – the top, and four sides.  At No Gaps Dental, we categorise filling complexity by the number of surfaces that has decay and therefore need to be filled.

Here is a simple overview of our filling categorisation:

What am I covered for?
It’s a good idea to regularly review your health insurance cover to make sure it covers you for the treatment you need. To review your cover, please contact your health insurer directly.

We will provide you with a treatment plan and can run a quote (for most health funds), and we will obtain your consent before undertaking any treatment.

What does the No Gaps Guarantee cover?
Our No Gaps Guarantee means no out-of-pocket expenses for your dental check-ups, teeth scaling & cleaning, fluoride applications, x-rays and simple fillings.

Our No Gaps Guarantee does not apply to all types of treatment. This is due to the declining rebates from health insurers and the rising costs of operating our practices. To remain sustainable while maintaining our commitment to delivering quality care and value to our patients, some treatments incur an out-of-pocket fee. This allows us to maintain the high standards of care and service that our patients deserve.

If you have any questions, please do not hesitate to reach out to our team.

There are many different health funds that offer dental cover. Each fund have their own way of determining the benefit they will cover for your dental treatment.

Here are some factors you want to consider when selecting the right dental cover for you;

Per person limits
It is important to know the limits each person can claim for dental treatment each year. If you have a family policy, consider whether the limit is per person or one limit for the whole family.

Percentage versus fixed
Health funds either pay up to a fixed amount towards your dental treatment, or they will pay a fixed percentage of the treatment costs, up to a fixed amount.

Annual limits
Health funds will always specify the maximum benefits they will pay each year, per person or family.

Coverage
Depending on the type of policy, dental cover will normally be divided into General Dental and Major dental. Your policy will state whether you are covered for either or both, and will also state limits per person specified for each category.

With our ‘No Gaps Guarantee’ we will accept the benefit paid by your health insurer as full payment, provided no limits have been reached, for our preventative and restorative treatments, including examinations, scale & cleaning, fluoride, x-rays, sealants and simple fillings.

If you have health insurance and you are covered for dental, the cost of your dental treatment will be paid for in 2 parts:

1. The benefit amount that your health insurer will pay
2. The out-of-pocket amount that you will need to pay

Every health insurer has their own method to determine the benefit amount they will pay towards your dental treatment.

Health insurers will normally pay on your behalf either a fix amount, or a fixed percentage of the treatment costs up until your annual limit.  The level of benefit paid by your health insurer will also depend on the policy you have taken out (e.g. Bronze, Silver or Gold)

For treatments that are covered under our No Gaps Policy, as long as you have met the conditions under the policy, the cost of your dental treatment will be covered by your health insurance.  That means that there is no out-of-pocket amount to be paid by you. For all other treatments, there will be an out-of-pocket amount that you will need to pay for.

When your dentist provides you with a treatment plan, you can contact your health insurer and request a quote to see how much benefit they will pay towards your treatment.  This will give you an idea of how much out-of-pocket you will need to pay.

A registered dentist is classified as a ‘Provider’ of Dental Services.

A ‘Preferred Provider’ is a dentist who has a contractual agreement with a specific health insurer, whereby the dentist agrees to provide certain treatments to the health fund member, at an agreed maximum price. The agreed maximum price is normally lower than the Provider’s (Dentist) normal prices.  For treatments that are not covered under our no gaps policy, this means that your out-of-pocket expense will be lower.

No Gaps Dental clinics are Preferred Providers with the following health insurers;

• Medibank Member’s Choice locations: Beverly Hills, Bondi Junction and Blacktown
• BUPA Member’s First Platinum locations: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Cabramatta, Chatswood, Epping, Hornsby, Penrith and Sydney Haymarket
• Westfund Provider of Choice: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Brookvale, Cabramatta, Chatswood, Epping, Hornsby, Liverpool, Parramatta, Penrith, Randwick, Sydney Haymarket and Sydney Wynyard.

If you are covered for dental by Private Health Insurance, we need your health fund card before we can make a claim.  Similar to the way we can use digital credit cards from our phones, several health insurance companies have digitised their membership cards.  This means that rather than having your physical health fund card in your wallet, you can add your Digital Health Fund card to your AppleWallet or GooglePay and tap on our HICAPS terminal to make your health fund claim.

Not all health funds have digitised their membership cards.  A digital health fund card is currently* available with the following health funds:

*The above list is current as of May 2023.  Please check your health fund’s website for more information on when a digital card might become available.

How to get your Digital Health Fund Card

To get your Digital Health Fund card, you will need to

1. Download the latest version of your Health Fund’s app from the AppStore (for Apple users) or GooglePlay (for Android users) to your phone or Apple watch
2. Set up your membership in the App. To do this, you will need your membership number and a few other details to verify your identity
3. Once set up, you can add your digital membership card to wallet. Each health fund does it differently, so please refer to your health funds website for further instructions

How to use your Digital Health Fund Card

To use your Digital Health Fund card,

1. Open up your AppleWallet or GooglePay and select your health fund card
2. When the HICAPS terminal is ready, hold your device near the HICAPS terminal reader and wait for it to read your card (usually a beep will sound)
3. If you have multiple members on your card, click on the eclipse symbol (three dots) to see your ID, or check from within the app and inform the receptionist so that the claim is made against the correct person
4. The claim will proceed as normal

If your health fund doesn’t have a Digital Health Fund card yet

If your health fund has not yet digitised their membership cards, you will need to bring your physical health fund card to your appointment in order to make a claim.  Digital technology is rapidly changing, so in time, more health funds will digitise their health fund cards as well.  Please check your health funds website for more information on when a digital card might become available.

Understanding how much benefit your health insurer will pay towards your dental treatment gives you an idea of how much you may need to pay out-of-pocket.

To find out your remaining benefit limits, you can call your health fund and ask simply ask ‘How much benefit do I have remaining?’, or you may be able to find limited information via your health fund app on your smart phone.  Depending on which level of cover you are on, and which health fund you are with, your limits may be split between:

• General Dental (check ups and cleans),
• Preventative Dental (fillings and fissure sealants) and
• Major Dental (includes extractions, gum treatment, crowns, root canal treatment, implants)

For a specific quote / estimate on the benefit your health insurer will pay towards your treatment, you will need to provide them with the following information:

1. Your name and member number
2. The Provider Number
   1. This is a 6 digit number that identifies the dentist
3. Treatment ID / Item Number
   1. This is a 3 digit number, usually before the treatment description
4. Tooth ID / Number
   1. This is required for treatment specific to a tooth such as a filling, crown, root canal treatment or extraction
5. Treatment Price

The above information can be obtained from your treatment plan. Without a treatment plan or undertaking an examination, it is difficult to know what treatment you need, and the item numbers to provide to the health fund.

When obtaining a quote /  estimate from your health insurer, please note that if anything changes in relation to your policy, claims you have made to date or when your benefits expire, your quote / estimate will also change.

Due to privacy reasons, our staff are not able to speak to your health insurer without your authorisation to do so first.

To make a claim from your health insurer in our clinics,

1. Bring your current health fund card to your appointment
2. At the end of the treatment, our receptionist will swipe your card through the HICAPS terminal.
3. Details of your treatment will be sent directly to your health insurer and it will be processed instantly on the spot.

We accept most Australian health insurers and most can be processed via HICAPS.

If your health fund card is not working, or you’ve forgotten your card, we can provide you with an invoice and receipt showing what you have paid on the day of your appointment.  You can take these documents to your heath insurer to make the claim directly with them either online or at a branch.

Most health insurers also have an App available on your smartphone, and claims can be submitted electronically via the App by uploading a copy of the invoice and / or submitting specific information from the invoice.

There are a number of reasons why your health insurer may not pay a benefit for your dental treatment.  When we process the claim using our HICAPS terminal, a reason may be provided and we can provide you with information on how to resolve it with your health insurer.  Sometimes a reason will not be provided, and you will need to contact your health insurer.  We are not able to do this on your behalf as it is between you and your health fund.

When making claims via the HICAPS terminal, the most common reasons why your health insurer is not paying a benefit for your treatment includes;

There are over one thousand item numbers covering the different types of dental treatment.

We have summarised the most common item numbers below;

Health Insurers normally split dental treatment into two categories:

1. General Dental and
2. Major Dental

General Dental covers the basic level of dental treatments and normally includes; examinations, dental check-ups, clean and polish, simple extractions, fillings and x-rays.

Major Dental is a higher level of cover, and normally covers root canal treatment, treating gum disease, crowns, bridges, dentures and veneers.

Before claiming a benefit for major dental treatment, the health insurer will usually impose a “waiting period” of 2 or so months.

At a minimum, almost all health funds will pay a benefit for two dental check-ups per year, and with our ‘No Gaps Guarantee’ there will be no out-of-pocket cost for these procedures.

Our No Gaps Guarantee covers Simple Fillings, but what is a simple filling?

A tooth consists of 5 surfaces – the top, and four sides.  At No Gaps Dental, we categorise filling complexity by the number of surfaces that has decay and therefore need to be filled.

Here is a simple overview of our filling categorisation:

What am I covered for?
It’s a good idea to regularly review your health insurance cover to make sure it covers you for the treatment you need. To review your cover, please contact your health insurer directly.

We will provide you with a treatment plan and can run a quote (for most health funds), and we will obtain your consent before undertaking any treatment.

What does the No Gaps Guarantee cover?
Our No Gaps Guarantee means no out-of-pocket expenses for your dental check-ups, teeth scaling & cleaning, fluoride applications, x-rays and simple fillings.

Our No Gaps Guarantee does not apply to all types of treatment. This is due to the declining rebates from health insurers and the rising costs of operating our practices. To remain sustainable while maintaining our commitment to delivering quality care and value to our patients, some treatments incur an out-of-pocket fee. This allows us to maintain the high standards of care and service that our patients deserve.

If you have any questions, please do not hesitate to reach out to our team.

There are many different health funds that offer dental cover. Each fund have their own way of determining the benefit they will cover for your dental treatment.

Here are some factors you want to consider when selecting the right dental cover for you;

Per person limits
It is important to know the limits each person can claim for dental treatment each year. If you have a family policy, consider whether the limit is per person or one limit for the whole family.

Percentage versus fixed
Health funds either pay up to a fixed amount towards your dental treatment, or they will pay a fixed percentage of the treatment costs, up to a fixed amount.

Annual limits
Health funds will always specify the maximum benefits they will pay each year, per person or family.

Coverage
Depending on the type of policy, dental cover will normally be divided into General Dental and Major dental. Your policy will state whether you are covered for either or both, and will also state limits per person specified for each category.

With our ‘No Gaps Guarantee’ we will accept the benefit paid by your health insurer as full payment, provided no limits have been reached, for our preventative and restorative treatments, including examinations, scale & cleaning, fluoride, x-rays, sealants and simple fillings.

If you have health insurance and you are covered for dental, the cost of your dental treatment will be paid for in 2 parts:

1. The benefit amount that your health insurer will pay
2. The out-of-pocket amount that you will need to pay

Every health insurer has their own method to determine the benefit amount they will pay towards your dental treatment.

Health insurers will normally pay on your behalf either a fix amount, or a fixed percentage of the treatment costs up until your annual limit.  The level of benefit paid by your health insurer will also depend on the policy you have taken out (e.g. Bronze, Silver or Gold)

For treatments that are covered under our No Gaps Policy, as long as you have met the conditions under the policy, the cost of your dental treatment will be covered by your health insurance.  That means that there is no out-of-pocket amount to be paid by you. For all other treatments, there will be an out-of-pocket amount that you will need to pay for.

When your dentist provides you with a treatment plan, you can contact your health insurer and request a quote to see how much benefit they will pay towards your treatment.  This will give you an idea of how much out-of-pocket you will need to pay.

A registered dentist is classified as a ‘Provider’ of Dental Services.

A ‘Preferred Provider’ is a dentist who has a contractual agreement with a specific health insurer, whereby the dentist agrees to provide certain treatments to the health fund member, at an agreed maximum price. The agreed maximum price is normally lower than the Provider’s (Dentist) normal prices.  For treatments that are not covered under our no gaps policy, this means that your out-of-pocket expense will be lower.

No Gaps Dental clinics are Preferred Providers with the following health insurers;

• Medibank Member’s Choice locations: Beverly Hills, Bondi Junction and Blacktown
• BUPA Member’s First Platinum locations: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Cabramatta, Chatswood, Epping, Hornsby, Penrith and Sydney Haymarket
• Westfund Provider of Choice: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Brookvale, Cabramatta, Chatswood, Epping, Hornsby, Liverpool, Parramatta, Penrith, Randwick, Sydney Haymarket and Sydney Wynyard.

If you are covered for dental by Private Health Insurance, we need your health fund card before we can make a claim.  Similar to the way we can use digital credit cards from our phones, several health insurance companies have digitised their membership cards.  This means that rather than having your physical health fund card in your wallet, you can add your Digital Health Fund card to your AppleWallet or GooglePay and tap on our HICAPS terminal to make your health fund claim.

Not all health funds have digitised their membership cards.  A digital health fund card is currently* available with the following health funds:

*The above list is current as of May 2023.  Please check your health fund’s website for more information on when a digital card might become available.

How to get your Digital Health Fund Card

To get your Digital Health Fund card, you will need to

1. Download the latest version of your Health Fund’s app from the AppStore (for Apple users) or GooglePlay (for Android users) to your phone or Apple watch
2. Set up your membership in the App. To do this, you will need your membership number and a few other details to verify your identity
3. Once set up, you can add your digital membership card to wallet. Each health fund does it differently, so please refer to your health funds website for further instructions

How to use your Digital Health Fund Card

To use your Digital Health Fund card,

1. Open up your AppleWallet or GooglePay and select your health fund card
2. When the HICAPS terminal is ready, hold your device near the HICAPS terminal reader and wait for it to read your card (usually a beep will sound)
3. If you have multiple members on your card, click on the eclipse symbol (three dots) to see your ID, or check from within the app and inform the receptionist so that the claim is made against the correct person
4. The claim will proceed as normal

If your health fund doesn’t have a Digital Health Fund card yet

If your health fund has not yet digitised their membership cards, you will need to bring your physical health fund card to your appointment in order to make a claim.  Digital technology is rapidly changing, so in time, more health funds will digitise their health fund cards as well.  Please check your health funds website for more information on when a digital card might become available.

Understanding how much benefit your health insurer will pay towards your dental treatment gives you an idea of how much you may need to pay out-of-pocket.

To find out your remaining benefit limits, you can call your health fund and ask simply ask ‘How much benefit do I have remaining?’, or you may be able to find limited information via your health fund app on your smart phone.  Depending on which level of cover you are on, and which health fund you are with, your limits may be split between:

• General Dental (check ups and cleans),
• Preventative Dental (fillings and fissure sealants) and
• Major Dental (includes extractions, gum treatment, crowns, root canal treatment, implants)

For a specific quote / estimate on the benefit your health insurer will pay towards your treatment, you will need to provide them with the following information:

1. Your name and member number
2. The Provider Number
   1. This is a 6 digit number that identifies the dentist
3. Treatment ID / Item Number
   1. This is a 3 digit number, usually before the treatment description
4. Tooth ID / Number
   1. This is required for treatment specific to a tooth such as a filling, crown, root canal treatment or extraction
5. Treatment Price

The above information can be obtained from your treatment plan. Without a treatment plan or undertaking an examination, it is difficult to know what treatment you need, and the item numbers to provide to the health fund.

When obtaining a quote /  estimate from your health insurer, please note that if anything changes in relation to your policy, claims you have made to date or when your benefits expire, your quote / estimate will also change.

Due to privacy reasons, our staff are not able to speak to your health insurer without your authorisation to do so first.

To make a claim from your health insurer in our clinics,

1. Bring your current health fund card to your appointment
2. At the end of the treatment, our receptionist will swipe your card through the HICAPS terminal.
3. Details of your treatment will be sent directly to your health insurer and it will be processed instantly on the spot.

We accept most Australian health insurers and most can be processed via HICAPS.

If your health fund card is not working, or you’ve forgotten your card, we can provide you with an invoice and receipt showing what you have paid on the day of your appointment.  You can take these documents to your heath insurer to make the claim directly with them either online or at a branch.

Most health insurers also have an App available on your smartphone, and claims can be submitted electronically via the App by uploading a copy of the invoice and / or submitting specific information from the invoice.

There are a number of reasons why your health insurer may not pay a benefit for your dental treatment.  When we process the claim using our HICAPS terminal, a reason may be provided and we can provide you with information on how to resolve it with your health insurer.  Sometimes a reason will not be provided, and you will need to contact your health insurer.  We are not able to do this on your behalf as it is between you and your health fund.

When making claims via the HICAPS terminal, the most common reasons why your health insurer is not paying a benefit for your treatment includes;

There are over one thousand item numbers covering the different types of dental treatment.

We have summarised the most common item numbers below;

Health Insurers normally split dental treatment into two categories:

1. General Dental and
2. Major Dental

General Dental covers the basic level of dental treatments and normally includes; examinations, dental check-ups, clean and polish, simple extractions, fillings and x-rays.

Major Dental is a higher level of cover, and normally covers root canal treatment, treating gum disease, crowns, bridges, dentures and veneers.

Before claiming a benefit for major dental treatment, the health insurer will usually impose a “waiting period” of 2 or so months.

At a minimum, almost all health funds will pay a benefit for two dental check-ups per year, and with our ‘No Gaps Guarantee’ there will be no out-of-pocket cost for these procedures.

Our No Gaps Guarantee covers Simple Fillings, but what is a simple filling?

A tooth consists of 5 surfaces – the top, and four sides.  At No Gaps Dental, we categorise filling complexity by the number of surfaces that has decay and therefore need to be filled.

Here is a simple overview of our filling categorisation:

What am I covered for?
It’s a good idea to regularly review your health insurance cover to make sure it covers you for the treatment you need. To review your cover, please contact your health insurer directly.

We will provide you with a treatment plan and can run a quote (for most health funds), and we will obtain your consent before undertaking any treatment.

What does the No Gaps Guarantee cover?
Our No Gaps Guarantee means no out-of-pocket expenses for your dental check-ups, teeth scaling & cleaning, fluoride applications, x-rays and simple fillings.

Our No Gaps Guarantee does not apply to all types of treatment. This is due to the declining rebates from health insurers and the rising costs of operating our practices. To remain sustainable while maintaining our commitment to delivering quality care and value to our patients, some treatments incur an out-of-pocket fee. This allows us to maintain the high standards of care and service that our patients deserve.

If you have any questions, please do not hesitate to reach out to our team.

There are many different health funds that offer dental cover. Each fund have their own way of determining the benefit they will cover for your dental treatment.

Here are some factors you want to consider when selecting the right dental cover for you;

Per person limits
It is important to know the limits each person can claim for dental treatment each year. If you have a family policy, consider whether the limit is per person or one limit for the whole family.

Percentage versus fixed
Health funds either pay up to a fixed amount towards your dental treatment, or they will pay a fixed percentage of the treatment costs, up to a fixed amount.

Annual limits
Health funds will always specify the maximum benefits they will pay each year, per person or family.

Coverage
Depending on the type of policy, dental cover will normally be divided into General Dental and Major dental. Your policy will state whether you are covered for either or both, and will also state limits per person specified for each category.

With our ‘No Gaps Guarantee’ we will accept the benefit paid by your health insurer as full payment, provided no limits have been reached, for our preventative and restorative treatments, including examinations, scale & cleaning, fluoride, x-rays, sealants and simple fillings.

If you have health insurance and you are covered for dental, the cost of your dental treatment will be paid for in 2 parts:

1. The benefit amount that your health insurer will pay
2. The out-of-pocket amount that you will need to pay

Every health insurer has their own method to determine the benefit amount they will pay towards your dental treatment.

Health insurers will normally pay on your behalf either a fix amount, or a fixed percentage of the treatment costs up until your annual limit.  The level of benefit paid by your health insurer will also depend on the policy you have taken out (e.g. Bronze, Silver or Gold)

For treatments that are covered under our No Gaps Policy, as long as you have met the conditions under the policy, the cost of your dental treatment will be covered by your health insurance.  That means that there is no out-of-pocket amount to be paid by you. For all other treatments, there will be an out-of-pocket amount that you will need to pay for.

When your dentist provides you with a treatment plan, you can contact your health insurer and request a quote to see how much benefit they will pay towards your treatment.  This will give you an idea of how much out-of-pocket you will need to pay.

A registered dentist is classified as a ‘Provider’ of Dental Services.

A ‘Preferred Provider’ is a dentist who has a contractual agreement with a specific health insurer, whereby the dentist agrees to provide certain treatments to the health fund member, at an agreed maximum price. The agreed maximum price is normally lower than the Provider’s (Dentist) normal prices.  For treatments that are not covered under our no gaps policy, this means that your out-of-pocket expense will be lower.

No Gaps Dental clinics are Preferred Providers with the following health insurers;

• Medibank Member’s Choice locations: Beverly Hills, Bondi Junction and Blacktown
• BUPA Member’s First Platinum locations: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Cabramatta, Chatswood, Epping, Hornsby, Penrith and Sydney Haymarket
• Westfund Provider of Choice: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Brookvale, Cabramatta, Chatswood, Epping, Hornsby, Liverpool, Parramatta, Penrith, Randwick, Sydney Haymarket and Sydney Wynyard.

If you are covered for dental by Private Health Insurance, we need your health fund card before we can make a claim.  Similar to the way we can use digital credit cards from our phones, several health insurance companies have digitised their membership cards.  This means that rather than having your physical health fund card in your wallet, you can add your Digital Health Fund card to your AppleWallet or GooglePay and tap on our HICAPS terminal to make your health fund claim.

Not all health funds have digitised their membership cards.  A digital health fund card is currently* available with the following health funds:

*The above list is current as of May 2023.  Please check your health fund’s website for more information on when a digital card might become available.

How to get your Digital Health Fund Card

To get your Digital Health Fund card, you will need to

1. Download the latest version of your Health Fund’s app from the AppStore (for Apple users) or GooglePlay (for Android users) to your phone or Apple watch
2. Set up your membership in the App. To do this, you will need your membership number and a few other details to verify your identity
3. Once set up, you can add your digital membership card to wallet. Each health fund does it differently, so please refer to your health funds website for further instructions

How to use your Digital Health Fund Card

To use your Digital Health Fund card,

1. Open up your AppleWallet or GooglePay and select your health fund card
2. When the HICAPS terminal is ready, hold your device near the HICAPS terminal reader and wait for it to read your card (usually a beep will sound)
3. If you have multiple members on your card, click on the eclipse symbol (three dots) to see your ID, or check from within the app and inform the receptionist so that the claim is made against the correct person
4. The claim will proceed as normal

If your health fund doesn’t have a Digital Health Fund card yet

If your health fund has not yet digitised their membership cards, you will need to bring your physical health fund card to your appointment in order to make a claim.  Digital technology is rapidly changing, so in time, more health funds will digitise their health fund cards as well.  Please check your health funds website for more information on when a digital card might become available.

Understanding how much benefit your health insurer will pay towards your dental treatment gives you an idea of how much you may need to pay out-of-pocket.

To find out your remaining benefit limits, you can call your health fund and ask simply ask ‘How much benefit do I have remaining?’, or you may be able to find limited information via your health fund app on your smart phone.  Depending on which level of cover you are on, and which health fund you are with, your limits may be split between:

• General Dental (check ups and cleans),
• Preventative Dental (fillings and fissure sealants) and
• Major Dental (includes extractions, gum treatment, crowns, root canal treatment, implants)

For a specific quote / estimate on the benefit your health insurer will pay towards your treatment, you will need to provide them with the following information:

1. Your name and member number
2. The Provider Number
   1. This is a 6 digit number that identifies the dentist
3. Treatment ID / Item Number
   1. This is a 3 digit number, usually before the treatment description
4. Tooth ID / Number
   1. This is required for treatment specific to a tooth such as a filling, crown, root canal treatment or extraction
5. Treatment Price

The above information can be obtained from your treatment plan. Without a treatment plan or undertaking an examination, it is difficult to know what treatment you need, and the item numbers to provide to the health fund.

When obtaining a quote /  estimate from your health insurer, please note that if anything changes in relation to your policy, claims you have made to date or when your benefits expire, your quote / estimate will also change.

Due to privacy reasons, our staff are not able to speak to your health insurer without your authorisation to do so first.

To make a claim from your health insurer in our clinics,

1. Bring your current health fund card to your appointment
2. At the end of the treatment, our receptionist will swipe your card through the HICAPS terminal.
3. Details of your treatment will be sent directly to your health insurer and it will be processed instantly on the spot.

We accept most Australian health insurers and most can be processed via HICAPS.

If your health fund card is not working, or you’ve forgotten your card, we can provide you with an invoice and receipt showing what you have paid on the day of your appointment.  You can take these documents to your heath insurer to make the claim directly with them either online or at a branch.

Most health insurers also have an App available on your smartphone, and claims can be submitted electronically via the App by uploading a copy of the invoice and / or submitting specific information from the invoice.

There are a number of reasons why your health insurer may not pay a benefit for your dental treatment.  When we process the claim using our HICAPS terminal, a reason may be provided and we can provide you with information on how to resolve it with your health insurer.  Sometimes a reason will not be provided, and you will need to contact your health insurer.  We are not able to do this on your behalf as it is between you and your health fund.

When making claims via the HICAPS terminal, the most common reasons why your health insurer is not paying a benefit for your treatment includes;

There are over one thousand item numbers covering the different types of dental treatment.

We have summarised the most common item numbers below;

Health Insurers normally split dental treatment into two categories:

1. General Dental and
2. Major Dental

General Dental covers the basic level of dental treatments and normally includes; examinations, dental check-ups, clean and polish, simple extractions, fillings and x-rays.

Major Dental is a higher level of cover, and normally covers root canal treatment, treating gum disease, crowns, bridges, dentures and veneers.

Before claiming a benefit for major dental treatment, the health insurer will usually impose a “waiting period” of 2 or so months.

At a minimum, almost all health funds will pay a benefit for two dental check-ups per year, and with our ‘No Gaps Guarantee’ there will be no out-of-pocket cost for these procedures.

Our No Gaps Guarantee covers Simple Fillings, but what is a simple filling?

A tooth consists of 5 surfaces – the top, and four sides.  At No Gaps Dental, we categorise filling complexity by the number of surfaces that has decay and therefore need to be filled.

Here is a simple overview of our filling categorisation:

What am I covered for?
It’s a good idea to regularly review your health insurance cover to make sure it covers you for the treatment you need. To review your cover, please contact your health insurer directly.

We will provide you with a treatment plan and can run a quote (for most health funds), and we will obtain your consent before undertaking any treatment.

What does the No Gaps Guarantee cover?
Our No Gaps Guarantee means no out-of-pocket expenses for your dental check-ups, teeth scaling & cleaning, fluoride applications, x-rays and simple fillings.

Our No Gaps Guarantee does not apply to all types of treatment. This is due to the declining rebates from health insurers and the rising costs of operating our practices. To remain sustainable while maintaining our commitment to delivering quality care and value to our patients, some treatments incur an out-of-pocket fee. This allows us to maintain the high standards of care and service that our patients deserve.

If you have any questions, please do not hesitate to reach out to our team.

There are many different health funds that offer dental cover. Each fund have their own way of determining the benefit they will cover for your dental treatment.

Here are some factors you want to consider when selecting the right dental cover for you;

Per person limits
It is important to know the limits each person can claim for dental treatment each year. If you have a family policy, consider whether the limit is per person or one limit for the whole family.

Percentage versus fixed
Health funds either pay up to a fixed amount towards your dental treatment, or they will pay a fixed percentage of the treatment costs, up to a fixed amount.

Annual limits
Health funds will always specify the maximum benefits they will pay each year, per person or family.

Coverage
Depending on the type of policy, dental cover will normally be divided into General Dental and Major dental. Your policy will state whether you are covered for either or both, and will also state limits per person specified for each category.

With our ‘No Gaps Guarantee’ we will accept the benefit paid by your health insurer as full payment, provided no limits have been reached, for our preventative and restorative treatments, including examinations, scale & cleaning, fluoride, x-rays, sealants and simple fillings.

If you have health insurance and you are covered for dental, the cost of your dental treatment will be paid for in 2 parts:

1. The benefit amount that your health insurer will pay
2. The out-of-pocket amount that you will need to pay

Every health insurer has their own method to determine the benefit amount they will pay towards your dental treatment.

Health insurers will normally pay on your behalf either a fix amount, or a fixed percentage of the treatment costs up until your annual limit.  The level of benefit paid by your health insurer will also depend on the policy you have taken out (e.g. Bronze, Silver or Gold)

For treatments that are covered under our No Gaps Policy, as long as you have met the conditions under the policy, the cost of your dental treatment will be covered by your health insurance.  That means that there is no out-of-pocket amount to be paid by you. For all other treatments, there will be an out-of-pocket amount that you will need to pay for.

When your dentist provides you with a treatment plan, you can contact your health insurer and request a quote to see how much benefit they will pay towards your treatment.  This will give you an idea of how much out-of-pocket you will need to pay.

A registered dentist is classified as a ‘Provider’ of Dental Services.

A ‘Preferred Provider’ is a dentist who has a contractual agreement with a specific health insurer, whereby the dentist agrees to provide certain treatments to the health fund member, at an agreed maximum price. The agreed maximum price is normally lower than the Provider’s (Dentist) normal prices.  For treatments that are not covered under our no gaps policy, this means that your out-of-pocket expense will be lower.

No Gaps Dental clinics are Preferred Providers with the following health insurers;

• Medibank Member’s Choice locations: Beverly Hills, Bondi Junction and Blacktown
• BUPA Member’s First Platinum locations: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Cabramatta, Chatswood, Epping, Hornsby, Penrith and Sydney Haymarket
• Westfund Provider of Choice: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Brookvale, Cabramatta, Chatswood, Epping, Hornsby, Liverpool, Parramatta, Penrith, Randwick, Sydney Haymarket and Sydney Wynyard.

If you are covered for dental by Private Health Insurance, we need your health fund card before we can make a claim.  Similar to the way we can use digital credit cards from our phones, several health insurance companies have digitised their membership cards.  This means that rather than having your physical health fund card in your wallet, you can add your Digital Health Fund card to your AppleWallet or GooglePay and tap on our HICAPS terminal to make your health fund claim.

Not all health funds have digitised their membership cards.  A digital health fund card is currently* available with the following health funds:

*The above list is current as of May 2023.  Please check your health fund’s website for more information on when a digital card might become available.

How to get your Digital Health Fund Card

To get your Digital Health Fund card, you will need to

1. Download the latest version of your Health Fund’s app from the AppStore (for Apple users) or GooglePlay (for Android users) to your phone or Apple watch
2. Set up your membership in the App. To do this, you will need your membership number and a few other details to verify your identity
3. Once set up, you can add your digital membership card to wallet. Each health fund does it differently, so please refer to your health funds website for further instructions

How to use your Digital Health Fund Card

To use your Digital Health Fund card,

1. Open up your AppleWallet or GooglePay and select your health fund card
2. When the HICAPS terminal is ready, hold your device near the HICAPS terminal reader and wait for it to read your card (usually a beep will sound)
3. If you have multiple members on your card, click on the eclipse symbol (three dots) to see your ID, or check from within the app and inform the receptionist so that the claim is made against the correct person
4. The claim will proceed as normal

If your health fund doesn’t have a Digital Health Fund card yet

If your health fund has not yet digitised their membership cards, you will need to bring your physical health fund card to your appointment in order to make a claim.  Digital technology is rapidly changing, so in time, more health funds will digitise their health fund cards as well.  Please check your health funds website for more information on when a digital card might become available.

Understanding how much benefit your health insurer will pay towards your dental treatment gives you an idea of how much you may need to pay out-of-pocket.

To find out your remaining benefit limits, you can call your health fund and ask simply ask ‘How much benefit do I have remaining?’, or you may be able to find limited information via your health fund app on your smart phone.  Depending on which level of cover you are on, and which health fund you are with, your limits may be split between:

• General Dental (check ups and cleans),
• Preventative Dental (fillings and fissure sealants) and
• Major Dental (includes extractions, gum treatment, crowns, root canal treatment, implants)

For a specific quote / estimate on the benefit your health insurer will pay towards your treatment, you will need to provide them with the following information:

1. Your name and member number
2. The Provider Number
   1. This is a 6 digit number that identifies the dentist
3. Treatment ID / Item Number
   1. This is a 3 digit number, usually before the treatment description
4. Tooth ID / Number
   1. This is required for treatment specific to a tooth such as a filling, crown, root canal treatment or extraction
5. Treatment Price

The above information can be obtained from your treatment plan. Without a treatment plan or undertaking an examination, it is difficult to know what treatment you need, and the item numbers to provide to the health fund.

When obtaining a quote /  estimate from your health insurer, please note that if anything changes in relation to your policy, claims you have made to date or when your benefits expire, your quote / estimate will also change.

Due to privacy reasons, our staff are not able to speak to your health insurer without your authorisation to do so first.

To make a claim from your health insurer in our clinics,

1. Bring your current health fund card to your appointment
2. At the end of the treatment, our receptionist will swipe your card through the HICAPS terminal.
3. Details of your treatment will be sent directly to your health insurer and it will be processed instantly on the spot.

We accept most Australian health insurers and most can be processed via HICAPS.

If your health fund card is not working, or you’ve forgotten your card, we can provide you with an invoice and receipt showing what you have paid on the day of your appointment.  You can take these documents to your heath insurer to make the claim directly with them either online or at a branch.

Most health insurers also have an App available on your smartphone, and claims can be submitted electronically via the App by uploading a copy of the invoice and / or submitting specific information from the invoice.

There are a number of reasons why your health insurer may not pay a benefit for your dental treatment.  When we process the claim using our HICAPS terminal, a reason may be provided and we can provide you with information on how to resolve it with your health insurer.  Sometimes a reason will not be provided, and you will need to contact your health insurer.  We are not able to do this on your behalf as it is between you and your health fund.

When making claims via the HICAPS terminal, the most common reasons why your health insurer is not paying a benefit for your treatment includes;

There are over one thousand item numbers covering the different types of dental treatment.

We have summarised the most common item numbers below;

Health Insurers normally split dental treatment into two categories:

1. General Dental and
2. Major Dental

General Dental covers the basic level of dental treatments and normally includes; examinations, dental check-ups, clean and polish, simple extractions, fillings and x-rays.

Major Dental is a higher level of cover, and normally covers root canal treatment, treating gum disease, crowns, bridges, dentures and veneers.

Before claiming a benefit for major dental treatment, the health insurer will usually impose a “waiting period” of 2 or so months.

At a minimum, almost all health funds will pay a benefit for two dental check-ups per year, and with our ‘No Gaps Guarantee’ there will be no out-of-pocket cost for these procedures.

Our No Gaps Guarantee covers Simple Fillings, but what is a simple filling?

A tooth consists of 5 surfaces – the top, and four sides.  At No Gaps Dental, we categorise filling complexity by the number of surfaces that has decay and therefore need to be filled.

Here is a simple overview of our filling categorisation:

What am I covered for?
It’s a good idea to regularly review your health insurance cover to make sure it covers you for the treatment you need. To review your cover, please contact your health insurer directly.

We will provide you with a treatment plan and can run a quote (for most health funds), and we will obtain your consent before undertaking any treatment.

What does the No Gaps Guarantee cover?
Our No Gaps Guarantee means no out-of-pocket expenses for your dental check-ups, teeth scaling & cleaning, fluoride applications, x-rays and simple fillings.

Our No Gaps Guarantee does not apply to all types of treatment. This is due to the declining rebates from health insurers and the rising costs of operating our practices. To remain sustainable while maintaining our commitment to delivering quality care and value to our patients, some treatments incur an out-of-pocket fee. This allows us to maintain the high standards of care and service that our patients deserve.

If you have any questions, please do not hesitate to reach out to our team.

There are many different health funds that offer dental cover. Each fund have their own way of determining the benefit they will cover for your dental treatment.

Here are some factors you want to consider when selecting the right dental cover for you;

Per person limits
It is important to know the limits each person can claim for dental treatment each year. If you have a family policy, consider whether the limit is per person or one limit for the whole family.

Percentage versus fixed
Health funds either pay up to a fixed amount towards your dental treatment, or they will pay a fixed percentage of the treatment costs, up to a fixed amount.

Annual limits
Health funds will always specify the maximum benefits they will pay each year, per person or family.

Coverage
Depending on the type of policy, dental cover will normally be divided into General Dental and Major dental. Your policy will state whether you are covered for either or both, and will also state limits per person specified for each category.

With our ‘No Gaps Guarantee’ we will accept the benefit paid by your health insurer as full payment, provided no limits have been reached, for our preventative and restorative treatments, including examinations, scale & cleaning, fluoride, x-rays, sealants and simple fillings.

If you have health insurance and you are covered for dental, the cost of your dental treatment will be paid for in 2 parts:

1. The benefit amount that your health insurer will pay
2. The out-of-pocket amount that you will need to pay

Every health insurer has their own method to determine the benefit amount they will pay towards your dental treatment.

Health insurers will normally pay on your behalf either a fix amount, or a fixed percentage of the treatment costs up until your annual limit.  The level of benefit paid by your health insurer will also depend on the policy you have taken out (e.g. Bronze, Silver or Gold)

For treatments that are covered under our No Gaps Policy, as long as you have met the conditions under the policy, the cost of your dental treatment will be covered by your health insurance.  That means that there is no out-of-pocket amount to be paid by you. For all other treatments, there will be an out-of-pocket amount that you will need to pay for.

When your dentist provides you with a treatment plan, you can contact your health insurer and request a quote to see how much benefit they will pay towards your treatment.  This will give you an idea of how much out-of-pocket you will need to pay.

A registered dentist is classified as a ‘Provider’ of Dental Services.

A ‘Preferred Provider’ is a dentist who has a contractual agreement with a specific health insurer, whereby the dentist agrees to provide certain treatments to the health fund member, at an agreed maximum price. The agreed maximum price is normally lower than the Provider’s (Dentist) normal prices.  For treatments that are not covered under our no gaps policy, this means that your out-of-pocket expense will be lower.

No Gaps Dental clinics are Preferred Providers with the following health insurers;

• Medibank Member’s Choice locations: Beverly Hills, Bondi Junction and Blacktown
• BUPA Member’s First Platinum locations: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Cabramatta, Chatswood, Epping, Hornsby, Penrith and Sydney Haymarket
• Westfund Provider of Choice: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Brookvale, Cabramatta, Chatswood, Epping, Hornsby, Liverpool, Parramatta, Penrith, Randwick, Sydney Haymarket and Sydney Wynyard.

If you are covered for dental by Private Health Insurance, we need your health fund card before we can make a claim.  Similar to the way we can use digital credit cards from our phones, several health insurance companies have digitised their membership cards.  This means that rather than having your physical health fund card in your wallet, you can add your Digital Health Fund card to your AppleWallet or GooglePay and tap on our HICAPS terminal to make your health fund claim.

Not all health funds have digitised their membership cards.  A digital health fund card is currently* available with the following health funds:

*The above list is current as of May 2023.  Please check your health fund’s website for more information on when a digital card might become available.

How to get your Digital Health Fund Card

To get your Digital Health Fund card, you will need to

1. Download the latest version of your Health Fund’s app from the AppStore (for Apple users) or GooglePlay (for Android users) to your phone or Apple watch
2. Set up your membership in the App. To do this, you will need your membership number and a few other details to verify your identity
3. Once set up, you can add your digital membership card to wallet. Each health fund does it differently, so please refer to your health funds website for further instructions

How to use your Digital Health Fund Card

To use your Digital Health Fund card,

1. Open up your AppleWallet or GooglePay and select your health fund card
2. When the HICAPS terminal is ready, hold your device near the HICAPS terminal reader and wait for it to read your card (usually a beep will sound)
3. If you have multiple members on your card, click on the eclipse symbol (three dots) to see your ID, or check from within the app and inform the receptionist so that the claim is made against the correct person
4. The claim will proceed as normal

If your health fund doesn’t have a Digital Health Fund card yet

If your health fund has not yet digitised their membership cards, you will need to bring your physical health fund card to your appointment in order to make a claim.  Digital technology is rapidly changing, so in time, more health funds will digitise their health fund cards as well.  Please check your health funds website for more information on when a digital card might become available.

Understanding how much benefit your health insurer will pay towards your dental treatment gives you an idea of how much you may need to pay out-of-pocket.

To find out your remaining benefit limits, you can call your health fund and ask simply ask ‘How much benefit do I have remaining?’, or you may be able to find limited information via your health fund app on your smart phone.  Depending on which level of cover you are on, and which health fund you are with, your limits may be split between:

• General Dental (check ups and cleans),
• Preventative Dental (fillings and fissure sealants) and
• Major Dental (includes extractions, gum treatment, crowns, root canal treatment, implants)

For a specific quote / estimate on the benefit your health insurer will pay towards your treatment, you will need to provide them with the following information:

1. Your name and member number
2. The Provider Number
   1. This is a 6 digit number that identifies the dentist
3. Treatment ID / Item Number
   1. This is a 3 digit number, usually before the treatment description
4. Tooth ID / Number
   1. This is required for treatment specific to a tooth such as a filling, crown, root canal treatment or extraction
5. Treatment Price

The above information can be obtained from your treatment plan. Without a treatment plan or undertaking an examination, it is difficult to know what treatment you need, and the item numbers to provide to the health fund.

When obtaining a quote /  estimate from your health insurer, please note that if anything changes in relation to your policy, claims you have made to date or when your benefits expire, your quote / estimate will also change.

Due to privacy reasons, our staff are not able to speak to your health insurer without your authorisation to do so first.

To make a claim from your health insurer in our clinics,

1. Bring your current health fund card to your appointment
2. At the end of the treatment, our receptionist will swipe your card through the HICAPS terminal.
3. Details of your treatment will be sent directly to your health insurer and it will be processed instantly on the spot.

We accept most Australian health insurers and most can be processed via HICAPS.

If your health fund card is not working, or you’ve forgotten your card, we can provide you with an invoice and receipt showing what you have paid on the day of your appointment.  You can take these documents to your heath insurer to make the claim directly with them either online or at a branch.

Most health insurers also have an App available on your smartphone, and claims can be submitted electronically via the App by uploading a copy of the invoice and / or submitting specific information from the invoice.

There are a number of reasons why your health insurer may not pay a benefit for your dental treatment.  When we process the claim using our HICAPS terminal, a reason may be provided and we can provide you with information on how to resolve it with your health insurer.  Sometimes a reason will not be provided, and you will need to contact your health insurer.  We are not able to do this on your behalf as it is between you and your health fund.

When making claims via the HICAPS terminal, the most common reasons why your health insurer is not paying a benefit for your treatment includes;

There are over one thousand item numbers covering the different types of dental treatment.

We have summarised the most common item numbers below;

Health Insurers normally split dental treatment into two categories:

1. General Dental and
2. Major Dental

General Dental covers the basic level of dental treatments and normally includes; examinations, dental check-ups, clean and polish, simple extractions, fillings and x-rays.

Major Dental is a higher level of cover, and normally covers root canal treatment, treating gum disease, crowns, bridges, dentures and veneers.

Before claiming a benefit for major dental treatment, the health insurer will usually impose a “waiting period” of 2 or so months.

At a minimum, almost all health funds will pay a benefit for two dental check-ups per year, and with our ‘No Gaps Guarantee’ there will be no out-of-pocket cost for these procedures.

Our No Gaps Guarantee covers Simple Fillings, but what is a simple filling?

A tooth consists of 5 surfaces – the top, and four sides.  At No Gaps Dental, we categorise filling complexity by the number of surfaces that has decay and therefore need to be filled.

Here is a simple overview of our filling categorisation:

What am I covered for?
It’s a good idea to regularly review your health insurance cover to make sure it covers you for the treatment you need. To review your cover, please contact your health insurer directly.

We will provide you with a treatment plan and can run a quote (for most health funds), and we will obtain your consent before undertaking any treatment.

What does the No Gaps Guarantee cover?
Our No Gaps Guarantee means no out-of-pocket expenses for your dental check-ups, teeth scaling & cleaning, fluoride applications, x-rays and simple fillings.

Our No Gaps Guarantee does not apply to all types of treatment. This is due to the declining rebates from health insurers and the rising costs of operating our practices. To remain sustainable while maintaining our commitment to delivering quality care and value to our patients, some treatments incur an out-of-pocket fee. This allows us to maintain the high standards of care and service that our patients deserve.

If you have any questions, please do not hesitate to reach out to our team.

There are many different health funds that offer dental cover. Each fund have their own way of determining the benefit they will cover for your dental treatment.

Here are some factors you want to consider when selecting the right dental cover for you;

Per person limits
It is important to know the limits each person can claim for dental treatment each year. If you have a family policy, consider whether the limit is per person or one limit for the whole family.

Percentage versus fixed
Health funds either pay up to a fixed amount towards your dental treatment, or they will pay a fixed percentage of the treatment costs, up to a fixed amount.

Annual limits
Health funds will always specify the maximum benefits they will pay each year, per person or family.

Coverage
Depending on the type of policy, dental cover will normally be divided into General Dental and Major dental. Your policy will state whether you are covered for either or both, and will also state limits per person specified for each category.

With our ‘No Gaps Guarantee’ we will accept the benefit paid by your health insurer as full payment, provided no limits have been reached, for our preventative and restorative treatments, including examinations, scale & cleaning, fluoride, x-rays, sealants and simple fillings.

If you have health insurance and you are covered for dental, the cost of your dental treatment will be paid for in 2 parts:

1. The benefit amount that your health insurer will pay
2. The out-of-pocket amount that you will need to pay

Every health insurer has their own method to determine the benefit amount they will pay towards your dental treatment.

Health insurers will normally pay on your behalf either a fix amount, or a fixed percentage of the treatment costs up until your annual limit.  The level of benefit paid by your health insurer will also depend on the policy you have taken out (e.g. Bronze, Silver or Gold)

For treatments that are covered under our No Gaps Policy, as long as you have met the conditions under the policy, the cost of your dental treatment will be covered by your health insurance.  That means that there is no out-of-pocket amount to be paid by you. For all other treatments, there will be an out-of-pocket amount that you will need to pay for.

When your dentist provides you with a treatment plan, you can contact your health insurer and request a quote to see how much benefit they will pay towards your treatment.  This will give you an idea of how much out-of-pocket you will need to pay.

A registered dentist is classified as a ‘Provider’ of Dental Services.

A ‘Preferred Provider’ is a dentist who has a contractual agreement with a specific health insurer, whereby the dentist agrees to provide certain treatments to the health fund member, at an agreed maximum price. The agreed maximum price is normally lower than the Provider’s (Dentist) normal prices.  For treatments that are not covered under our no gaps policy, this means that your out-of-pocket expense will be lower.

No Gaps Dental clinics are Preferred Providers with the following health insurers;

• Medibank Member’s Choice locations: Beverly Hills, Bondi Junction and Blacktown
• BUPA Member’s First Platinum locations: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Cabramatta, Chatswood, Epping, Hornsby, Penrith and Sydney Haymarket
• Westfund Provider of Choice: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Brookvale, Cabramatta, Chatswood, Epping, Hornsby, Liverpool, Parramatta, Penrith, Randwick, Sydney Haymarket and Sydney Wynyard.

If you are covered for dental by Private Health Insurance, we need your health fund card before we can make a claim.  Similar to the way we can use digital credit cards from our phones, several health insurance companies have digitised their membership cards.  This means that rather than having your physical health fund card in your wallet, you can add your Digital Health Fund card to your AppleWallet or GooglePay and tap on our HICAPS terminal to make your health fund claim.

Not all health funds have digitised their membership cards.  A digital health fund card is currently* available with the following health funds:

*The above list is current as of May 2023.  Please check your health fund’s website for more information on when a digital card might become available.

How to get your Digital Health Fund Card

To get your Digital Health Fund card, you will need to

1. Download the latest version of your Health Fund’s app from the AppStore (for Apple users) or GooglePlay (for Android users) to your phone or Apple watch
2. Set up your membership in the App. To do this, you will need your membership number and a few other details to verify your identity
3. Once set up, you can add your digital membership card to wallet. Each health fund does it differently, so please refer to your health funds website for further instructions

How to use your Digital Health Fund Card

To use your Digital Health Fund card,

1. Open up your AppleWallet or GooglePay and select your health fund card
2. When the HICAPS terminal is ready, hold your device near the HICAPS terminal reader and wait for it to read your card (usually a beep will sound)
3. If you have multiple members on your card, click on the eclipse symbol (three dots) to see your ID, or check from within the app and inform the receptionist so that the claim is made against the correct person
4. The claim will proceed as normal

If your health fund doesn’t have a Digital Health Fund card yet

If your health fund has not yet digitised their membership cards, you will need to bring your physical health fund card to your appointment in order to make a claim.  Digital technology is rapidly changing, so in time, more health funds will digitise their health fund cards as well.  Please check your health funds website for more information on when a digital card might become available.

Understanding how much benefit your health insurer will pay towards your dental treatment gives you an idea of how much you may need to pay out-of-pocket.

To find out your remaining benefit limits, you can call your health fund and ask simply ask ‘How much benefit do I have remaining?’, or you may be able to find limited information via your health fund app on your smart phone.  Depending on which level of cover you are on, and which health fund you are with, your limits may be split between:

• General Dental (check ups and cleans),
• Preventative Dental (fillings and fissure sealants) and
• Major Dental (includes extractions, gum treatment, crowns, root canal treatment, implants)

For a specific quote / estimate on the benefit your health insurer will pay towards your treatment, you will need to provide them with the following information:

1. Your name and member number
2. The Provider Number
   1. This is a 6 digit number that identifies the dentist
3. Treatment ID / Item Number
   1. This is a 3 digit number, usually before the treatment description
4. Tooth ID / Number
   1. This is required for treatment specific to a tooth such as a filling, crown, root canal treatment or extraction
5. Treatment Price

The above information can be obtained from your treatment plan. Without a treatment plan or undertaking an examination, it is difficult to know what treatment you need, and the item numbers to provide to the health fund.

When obtaining a quote /  estimate from your health insurer, please note that if anything changes in relation to your policy, claims you have made to date or when your benefits expire, your quote / estimate will also change.

Due to privacy reasons, our staff are not able to speak to your health insurer without your authorisation to do so first.

To make a claim from your health insurer in our clinics,

1. Bring your current health fund card to your appointment
2. At the end of the treatment, our receptionist will swipe your card through the HICAPS terminal.
3. Details of your treatment will be sent directly to your health insurer and it will be processed instantly on the spot.

We accept most Australian health insurers and most can be processed via HICAPS.

If your health fund card is not working, or you’ve forgotten your card, we can provide you with an invoice and receipt showing what you have paid on the day of your appointment.  You can take these documents to your heath insurer to make the claim directly with them either online or at a branch.

Most health insurers also have an App available on your smartphone, and claims can be submitted electronically via the App by uploading a copy of the invoice and / or submitting specific information from the invoice.

There are a number of reasons why your health insurer may not pay a benefit for your dental treatment.  When we process the claim using our HICAPS terminal, a reason may be provided and we can provide you with information on how to resolve it with your health insurer.  Sometimes a reason will not be provided, and you will need to contact your health insurer.  We are not able to do this on your behalf as it is between you and your health fund.

When making claims via the HICAPS terminal, the most common reasons why your health insurer is not paying a benefit for your treatment includes;

There are over one thousand item numbers covering the different types of dental treatment.

We have summarised the most common item numbers below;

Health Insurers normally split dental treatment into two categories:

1. General Dental and
2. Major Dental

General Dental covers the basic level of dental treatments and normally includes; examinations, dental check-ups, clean and polish, simple extractions, fillings and x-rays.

Major Dental is a higher level of cover, and normally covers root canal treatment, treating gum disease, crowns, bridges, dentures and veneers.

Before claiming a benefit for major dental treatment, the health insurer will usually impose a “waiting period” of 2 or so months.

At a minimum, almost all health funds will pay a benefit for two dental check-ups per year, and with our ‘No Gaps Guarantee’ there will be no out-of-pocket cost for these procedures.

Our No Gaps Guarantee covers Simple Fillings, but what is a simple filling?

A tooth consists of 5 surfaces – the top, and four sides.  At No Gaps Dental, we categorise filling complexity by the number of surfaces that has decay and therefore need to be filled.

Here is a simple overview of our filling categorisation:

What am I covered for?
It’s a good idea to regularly review your health insurance cover to make sure it covers you for the treatment you need. To review your cover, please contact your health insurer directly.

We will provide you with a treatment plan and can run a quote (for most health funds), and we will obtain your consent before undertaking any treatment.

What does the No Gaps Guarantee cover?
Our No Gaps Guarantee means no out-of-pocket expenses for your dental check-ups, teeth scaling & cleaning, fluoride applications, x-rays and simple fillings.

Our No Gaps Guarantee does not apply to all types of treatment. This is due to the declining rebates from health insurers and the rising costs of operating our practices. To remain sustainable while maintaining our commitment to delivering quality care and value to our patients, some treatments incur an out-of-pocket fee. This allows us to maintain the high standards of care and service that our patients deserve.

If you have any questions, please do not hesitate to reach out to our team.

There are many different health funds that offer dental cover. Each fund have their own way of determining the benefit they will cover for your dental treatment.

Here are some factors you want to consider when selecting the right dental cover for you;

Per person limits
It is important to know the limits each person can claim for dental treatment each year. If you have a family policy, consider whether the limit is per person or one limit for the whole family.

Percentage versus fixed
Health funds either pay up to a fixed amount towards your dental treatment, or they will pay a fixed percentage of the treatment costs, up to a fixed amount.

Annual limits
Health funds will always specify the maximum benefits they will pay each year, per person or family.

Coverage
Depending on the type of policy, dental cover will normally be divided into General Dental and Major dental. Your policy will state whether you are covered for either or both, and will also state limits per person specified for each category.

With our ‘No Gaps Guarantee’ we will accept the benefit paid by your health insurer as full payment, provided no limits have been reached, for our preventative and restorative treatments, including examinations, scale & cleaning, fluoride, x-rays, sealants and simple fillings.

If you have health insurance and you are covered for dental, the cost of your dental treatment will be paid for in 2 parts:

1. The benefit amount that your health insurer will pay
2. The out-of-pocket amount that you will need to pay

Every health insurer has their own method to determine the benefit amount they will pay towards your dental treatment.

Health insurers will normally pay on your behalf either a fix amount, or a fixed percentage of the treatment costs up until your annual limit.  The level of benefit paid by your health insurer will also depend on the policy you have taken out (e.g. Bronze, Silver or Gold)

For treatments that are covered under our No Gaps Policy, as long as you have met the conditions under the policy, the cost of your dental treatment will be covered by your health insurance.  That means that there is no out-of-pocket amount to be paid by you. For all other treatments, there will be an out-of-pocket amount that you will need to pay for.

When your dentist provides you with a treatment plan, you can contact your health insurer and request a quote to see how much benefit they will pay towards your treatment.  This will give you an idea of how much out-of-pocket you will need to pay.

A registered dentist is classified as a ‘Provider’ of Dental Services.

A ‘Preferred Provider’ is a dentist who has a contractual agreement with a specific health insurer, whereby the dentist agrees to provide certain treatments to the health fund member, at an agreed maximum price. The agreed maximum price is normally lower than the Provider’s (Dentist) normal prices.  For treatments that are not covered under our no gaps policy, this means that your out-of-pocket expense will be lower.

No Gaps Dental clinics are Preferred Providers with the following health insurers;

• Medibank Member’s Choice locations: Beverly Hills, Bondi Junction and Blacktown
• BUPA Member’s First Platinum locations: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Cabramatta, Chatswood, Epping, Hornsby, Penrith and Sydney Haymarket
• Westfund Provider of Choice: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Brookvale, Cabramatta, Chatswood, Epping, Hornsby, Liverpool, Parramatta, Penrith, Randwick, Sydney Haymarket and Sydney Wynyard.

If you are covered for dental by Private Health Insurance, we need your health fund card before we can make a claim.  Similar to the way we can use digital credit cards from our phones, several health insurance companies have digitised their membership cards.  This means that rather than having your physical health fund card in your wallet, you can add your Digital Health Fund card to your AppleWallet or GooglePay and tap on our HICAPS terminal to make your health fund claim.

Not all health funds have digitised their membership cards.  A digital health fund card is currently* available with the following health funds:

*The above list is current as of May 2023.  Please check your health fund’s website for more information on when a digital card might become available.

How to get your Digital Health Fund Card

To get your Digital Health Fund card, you will need to

1. Download the latest version of your Health Fund’s app from the AppStore (for Apple users) or GooglePlay (for Android users) to your phone or Apple watch
2. Set up your membership in the App. To do this, you will need your membership number and a few other details to verify your identity
3. Once set up, you can add your digital membership card to wallet. Each health fund does it differently, so please refer to your health funds website for further instructions

How to use your Digital Health Fund Card

To use your Digital Health Fund card,

1. Open up your AppleWallet or GooglePay and select your health fund card
2. When the HICAPS terminal is ready, hold your device near the HICAPS terminal reader and wait for it to read your card (usually a beep will sound)
3. If you have multiple members on your card, click on the eclipse symbol (three dots) to see your ID, or check from within the app and inform the receptionist so that the claim is made against the correct person
4. The claim will proceed as normal

If your health fund doesn’t have a Digital Health Fund card yet

If your health fund has not yet digitised their membership cards, you will need to bring your physical health fund card to your appointment in order to make a claim.  Digital technology is rapidly changing, so in time, more health funds will digitise their health fund cards as well.  Please check your health funds website for more information on when a digital card might become available.

Understanding how much benefit your health insurer will pay towards your dental treatment gives you an idea of how much you may need to pay out-of-pocket.

To find out your remaining benefit limits, you can call your health fund and ask simply ask ‘How much benefit do I have remaining?’, or you may be able to find limited information via your health fund app on your smart phone.  Depending on which level of cover you are on, and which health fund you are with, your limits may be split between:

• General Dental (check ups and cleans),
• Preventative Dental (fillings and fissure sealants) and
• Major Dental (includes extractions, gum treatment, crowns, root canal treatment, implants)

For a specific quote / estimate on the benefit your health insurer will pay towards your treatment, you will need to provide them with the following information:

1. Your name and member number
2. The Provider Number
   1. This is a 6 digit number that identifies the dentist
3. Treatment ID / Item Number
   1. This is a 3 digit number, usually before the treatment description
4. Tooth ID / Number
   1. This is required for treatment specific to a tooth such as a filling, crown, root canal treatment or extraction
5. Treatment Price

The above information can be obtained from your treatment plan. Without a treatment plan or undertaking an examination, it is difficult to know what treatment you need, and the item numbers to provide to the health fund.

When obtaining a quote /  estimate from your health insurer, please note that if anything changes in relation to your policy, claims you have made to date or when your benefits expire, your quote / estimate will also change.

Due to privacy reasons, our staff are not able to speak to your health insurer without your authorisation to do so first.

To make a claim from your health insurer in our clinics,

1. Bring your current health fund card to your appointment
2. At the end of the treatment, our receptionist will swipe your card through the HICAPS terminal.
3. Details of your treatment will be sent directly to your health insurer and it will be processed instantly on the spot.

We accept most Australian health insurers and most can be processed via HICAPS.

If your health fund card is not working, or you’ve forgotten your card, we can provide you with an invoice and receipt showing what you have paid on the day of your appointment.  You can take these documents to your heath insurer to make the claim directly with them either online or at a branch.

Most health insurers also have an App available on your smartphone, and claims can be submitted electronically via the App by uploading a copy of the invoice and / or submitting specific information from the invoice.

There are a number of reasons why your health insurer may not pay a benefit for your dental treatment.  When we process the claim using our HICAPS terminal, a reason may be provided and we can provide you with information on how to resolve it with your health insurer.  Sometimes a reason will not be provided, and you will need to contact your health insurer.  We are not able to do this on your behalf as it is between you and your health fund.

When making claims via the HICAPS terminal, the most common reasons why your health insurer is not paying a benefit for your treatment includes;

There are over one thousand item numbers covering the different types of dental treatment.

We have summarised the most common item numbers below;

Health Insurers normally split dental treatment into two categories:

1. General Dental and
2. Major Dental

General Dental covers the basic level of dental treatments and normally includes; examinations, dental check-ups, clean and polish, simple extractions, fillings and x-rays.

Major Dental is a higher level of cover, and normally covers root canal treatment, treating gum disease, crowns, bridges, dentures and veneers.

Before claiming a benefit for major dental treatment, the health insurer will usually impose a “waiting period” of 2 or so months.

At a minimum, almost all health funds will pay a benefit for two dental check-ups per year, and with our ‘No Gaps Guarantee’ there will be no out-of-pocket cost for these procedures.

Our No Gaps Guarantee covers Simple Fillings, but what is a simple filling?

A tooth consists of 5 surfaces – the top, and four sides.  At No Gaps Dental, we categorise filling complexity by the number of surfaces that has decay and therefore need to be filled.

Here is a simple overview of our filling categorisation:

What am I covered for?
It’s a good idea to regularly review your health insurance cover to make sure it covers you for the treatment you need. To review your cover, please contact your health insurer directly.

We will provide you with a treatment plan and can run a quote (for most health funds), and we will obtain your consent before undertaking any treatment.

What does the No Gaps Guarantee cover?
Our No Gaps Guarantee means no out-of-pocket expenses for your dental check-ups, teeth scaling & cleaning, fluoride applications, x-rays and simple fillings.

Our No Gaps Guarantee does not apply to all types of treatment. This is due to the declining rebates from health insurers and the rising costs of operating our practices. To remain sustainable while maintaining our commitment to delivering quality care and value to our patients, some treatments incur an out-of-pocket fee. This allows us to maintain the high standards of care and service that our patients deserve.

If you have any questions, please do not hesitate to reach out to our team.

There are many different health funds that offer dental cover. Each fund have their own way of determining the benefit they will cover for your dental treatment.

Here are some factors you want to consider when selecting the right dental cover for you;

Per person limits
It is important to know the limits each person can claim for dental treatment each year. If you have a family policy, consider whether the limit is per person or one limit for the whole family.

Percentage versus fixed
Health funds either pay up to a fixed amount towards your dental treatment, or they will pay a fixed percentage of the treatment costs, up to a fixed amount.

Annual limits
Health funds will always specify the maximum benefits they will pay each year, per person or family.

Coverage
Depending on the type of policy, dental cover will normally be divided into General Dental and Major dental. Your policy will state whether you are covered for either or both, and will also state limits per person specified for each category.

With our ‘No Gaps Guarantee’ we will accept the benefit paid by your health insurer as full payment, provided no limits have been reached, for our preventative and restorative treatments, including examinations, scale & cleaning, fluoride, x-rays, sealants and simple fillings.

If you have health insurance and you are covered for dental, the cost of your dental treatment will be paid for in 2 parts:

1. The benefit amount that your health insurer will pay
2. The out-of-pocket amount that you will need to pay

Every health insurer has their own method to determine the benefit amount they will pay towards your dental treatment.

Health insurers will normally pay on your behalf either a fix amount, or a fixed percentage of the treatment costs up until your annual limit.  The level of benefit paid by your health insurer will also depend on the policy you have taken out (e.g. Bronze, Silver or Gold)

For treatments that are covered under our No Gaps Policy, as long as you have met the conditions under the policy, the cost of your dental treatment will be covered by your health insurance.  That means that there is no out-of-pocket amount to be paid by you. For all other treatments, there will be an out-of-pocket amount that you will need to pay for.

When your dentist provides you with a treatment plan, you can contact your health insurer and request a quote to see how much benefit they will pay towards your treatment.  This will give you an idea of how much out-of-pocket you will need to pay.

A registered dentist is classified as a ‘Provider’ of Dental Services.

A ‘Preferred Provider’ is a dentist who has a contractual agreement with a specific health insurer, whereby the dentist agrees to provide certain treatments to the health fund member, at an agreed maximum price. The agreed maximum price is normally lower than the Provider’s (Dentist) normal prices.  For treatments that are not covered under our no gaps policy, this means that your out-of-pocket expense will be lower.

No Gaps Dental clinics are Preferred Providers with the following health insurers;

• Medibank Member’s Choice locations: Beverly Hills, Bondi Junction and Blacktown
• BUPA Member’s First Platinum locations: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Cabramatta, Chatswood, Epping, Hornsby, Penrith and Sydney Haymarket
• Westfund Provider of Choice: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Brookvale, Cabramatta, Chatswood, Epping, Hornsby, Liverpool, Parramatta, Penrith, Randwick, Sydney Haymarket and Sydney Wynyard.

If you are covered for dental by Private Health Insurance, we need your health fund card before we can make a claim.  Similar to the way we can use digital credit cards from our phones, several health insurance companies have digitised their membership cards.  This means that rather than having your physical health fund card in your wallet, you can add your Digital Health Fund card to your AppleWallet or GooglePay and tap on our HICAPS terminal to make your health fund claim.

Not all health funds have digitised their membership cards.  A digital health fund card is currently* available with the following health funds:

*The above list is current as of May 2023.  Please check your health fund’s website for more information on when a digital card might become available.

How to get your Digital Health Fund Card

To get your Digital Health Fund card, you will need to

1. Download the latest version of your Health Fund’s app from the AppStore (for Apple users) or GooglePlay (for Android users) to your phone or Apple watch
2. Set up your membership in the App. To do this, you will need your membership number and a few other details to verify your identity
3. Once set up, you can add your digital membership card to wallet. Each health fund does it differently, so please refer to your health funds website for further instructions

How to use your Digital Health Fund Card

To use your Digital Health Fund card,

1. Open up your AppleWallet or GooglePay and select your health fund card
2. When the HICAPS terminal is ready, hold your device near the HICAPS terminal reader and wait for it to read your card (usually a beep will sound)
3. If you have multiple members on your card, click on the eclipse symbol (three dots) to see your ID, or check from within the app and inform the receptionist so that the claim is made against the correct person
4. The claim will proceed as normal

If your health fund doesn’t have a Digital Health Fund card yet

If your health fund has not yet digitised their membership cards, you will need to bring your physical health fund card to your appointment in order to make a claim.  Digital technology is rapidly changing, so in time, more health funds will digitise their health fund cards as well.  Please check your health funds website for more information on when a digital card might become available.

Understanding how much benefit your health insurer will pay towards your dental treatment gives you an idea of how much you may need to pay out-of-pocket.

To find out your remaining benefit limits, you can call your health fund and ask simply ask ‘How much benefit do I have remaining?’, or you may be able to find limited information via your health fund app on your smart phone.  Depending on which level of cover you are on, and which health fund you are with, your limits may be split between:

• General Dental (check ups and cleans),
• Preventative Dental (fillings and fissure sealants) and
• Major Dental (includes extractions, gum treatment, crowns, root canal treatment, implants)

For a specific quote / estimate on the benefit your health insurer will pay towards your treatment, you will need to provide them with the following information:

1. Your name and member number
2. The Provider Number
   1. This is a 6 digit number that identifies the dentist
3. Treatment ID / Item Number
   1. This is a 3 digit number, usually before the treatment description
4. Tooth ID / Number
   1. This is required for treatment specific to a tooth such as a filling, crown, root canal treatment or extraction
5. Treatment Price

The above information can be obtained from your treatment plan. Without a treatment plan or undertaking an examination, it is difficult to know what treatment you need, and the item numbers to provide to the health fund.

When obtaining a quote /  estimate from your health insurer, please note that if anything changes in relation to your policy, claims you have made to date or when your benefits expire, your quote / estimate will also change.

Due to privacy reasons, our staff are not able to speak to your health insurer without your authorisation to do so first.

To make a claim from your health insurer in our clinics,

1. Bring your current health fund card to your appointment
2. At the end of the treatment, our receptionist will swipe your card through the HICAPS terminal.
3. Details of your treatment will be sent directly to your health insurer and it will be processed instantly on the spot.

We accept most Australian health insurers and most can be processed via HICAPS.

If your health fund card is not working, or you’ve forgotten your card, we can provide you with an invoice and receipt showing what you have paid on the day of your appointment.  You can take these documents to your heath insurer to make the claim directly with them either online or at a branch.

Most health insurers also have an App available on your smartphone, and claims can be submitted electronically via the App by uploading a copy of the invoice and / or submitting specific information from the invoice.

There are a number of reasons why your health insurer may not pay a benefit for your dental treatment.  When we process the claim using our HICAPS terminal, a reason may be provided and we can provide you with information on how to resolve it with your health insurer.  Sometimes a reason will not be provided, and you will need to contact your health insurer.  We are not able to do this on your behalf as it is between you and your health fund.

When making claims via the HICAPS terminal, the most common reasons why your health insurer is not paying a benefit for your treatment includes;

There are over one thousand item numbers covering the different types of dental treatment.

We have summarised the most common item numbers below;

Health Insurers normally split dental treatment into two categories:

1. General Dental and
2. Major Dental

General Dental covers the basic level of dental treatments and normally includes; examinations, dental check-ups, clean and polish, simple extractions, fillings and x-rays.

Major Dental is a higher level of cover, and normally covers root canal treatment, treating gum disease, crowns, bridges, dentures and veneers.

Before claiming a benefit for major dental treatment, the health insurer will usually impose a “waiting period” of 2 or so months.

At a minimum, almost all health funds will pay a benefit for two dental check-ups per year, and with our ‘No Gaps Guarantee’ there will be no out-of-pocket cost for these procedures.

Our No Gaps Guarantee covers Simple Fillings, but what is a simple filling?

A tooth consists of 5 surfaces – the top, and four sides.  At No Gaps Dental, we categorise filling complexity by the number of surfaces that has decay and therefore need to be filled.

Here is a simple overview of our filling categorisation:

What am I covered for?
It’s a good idea to regularly review your health insurance cover to make sure it covers you for the treatment you need. To review your cover, please contact your health insurer directly.

We will provide you with a treatment plan and can run a quote (for most health funds), and we will obtain your consent before undertaking any treatment.

What does the No Gaps Guarantee cover?
Our No Gaps Guarantee means no out-of-pocket expenses for your dental check-ups, teeth scaling & cleaning, fluoride applications, x-rays and simple fillings.

Our No Gaps Guarantee does not apply to all types of treatment. This is due to the declining rebates from health insurers and the rising costs of operating our practices. To remain sustainable while maintaining our commitment to delivering quality care and value to our patients, some treatments incur an out-of-pocket fee. This allows us to maintain the high standards of care and service that our patients deserve.

If you have any questions, please do not hesitate to reach out to our team.

There are many different health funds that offer dental cover. Each fund have their own way of determining the benefit they will cover for your dental treatment.

Here are some factors you want to consider when selecting the right dental cover for you;

Per person limits
It is important to know the limits each person can claim for dental treatment each year. If you have a family policy, consider whether the limit is per person or one limit for the whole family.

Percentage versus fixed
Health funds either pay up to a fixed amount towards your dental treatment, or they will pay a fixed percentage of the treatment costs, up to a fixed amount.

Annual limits
Health funds will always specify the maximum benefits they will pay each year, per person or family.

Coverage
Depending on the type of policy, dental cover will normally be divided into General Dental and Major dental. Your policy will state whether you are covered for either or both, and will also state limits per person specified for each category.

With our ‘No Gaps Guarantee’ we will accept the benefit paid by your health insurer as full payment, provided no limits have been reached, for our preventative and restorative treatments, including examinations, scale & cleaning, fluoride, x-rays, sealants and simple fillings.

If you have health insurance and you are covered for dental, the cost of your dental treatment will be paid for in 2 parts:

1. The benefit amount that your health insurer will pay
2. The out-of-pocket amount that you will need to pay

Every health insurer has their own method to determine the benefit amount they will pay towards your dental treatment.

Health insurers will normally pay on your behalf either a fix amount, or a fixed percentage of the treatment costs up until your annual limit.  The level of benefit paid by your health insurer will also depend on the policy you have taken out (e.g. Bronze, Silver or Gold)

For treatments that are covered under our No Gaps Policy, as long as you have met the conditions under the policy, the cost of your dental treatment will be covered by your health insurance.  That means that there is no out-of-pocket amount to be paid by you. For all other treatments, there will be an out-of-pocket amount that you will need to pay for.

When your dentist provides you with a treatment plan, you can contact your health insurer and request a quote to see how much benefit they will pay towards your treatment.  This will give you an idea of how much out-of-pocket you will need to pay.

A registered dentist is classified as a ‘Provider’ of Dental Services.

A ‘Preferred Provider’ is a dentist who has a contractual agreement with a specific health insurer, whereby the dentist agrees to provide certain treatments to the health fund member, at an agreed maximum price. The agreed maximum price is normally lower than the Provider’s (Dentist) normal prices.  For treatments that are not covered under our no gaps policy, this means that your out-of-pocket expense will be lower.

No Gaps Dental clinics are Preferred Providers with the following health insurers;

• Medibank Member’s Choice locations: Beverly Hills, Bondi Junction and Blacktown
• BUPA Member’s First Platinum locations: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Cabramatta, Chatswood, Epping, Hornsby, Penrith and Sydney Haymarket
• Westfund Provider of Choice: Artarmon, Beverly Hills, Blacktown, Bondi Junction, Brookvale, Cabramatta, Chatswood, Epping, Hornsby, Liverpool, Parramatta, Penrith, Randwick, Sydney Haymarket and Sydney Wynyard.

If you are covered for dental by Private Health Insurance, we need your health fund card before we can make a claim.  Similar to the way we can use digital credit cards from our phones, several health insurance companies have digitised their membership cards.  This means that rather than having your physical health fund card in your wallet, you can add your Digital Health Fund card to your AppleWallet or GooglePay and tap on our HICAPS terminal to make your health fund claim.

Not all health funds have digitised their membership cards.  A digital health fund card is currently* available with the following health funds:

*The above list is current as of May 2023.  Please check your health fund’s website for more information on when a digital card might become available.

How to get your Digital Health Fund Card

To get your Digital Health Fund card, you will need to

1. Download the latest version of your Health Fund’s app from the AppStore (for Apple users) or GooglePlay (for Android users) to your phone or Apple watch
2. Set up your membership in the App. To do this, you will need your membership number and a few other details to verify your identity
3. Once set up, you can add your digital membership card to wallet. Each health fund does it differently, so please refer to your health funds website for further instructions

How to use your Digital Health Fund Card

To use your Digital Health Fund card,

1. Open up your AppleWallet or GooglePay and select your health fund card
2. When the HICAPS terminal is ready, hold your device near the HICAPS terminal reader and wait for it to read your card (usually a beep will sound)
3. If you have multiple members on your card, click on the eclipse symbol (three dots) to see your ID, or check from within the app and inform the receptionist so that the claim is made against the correct person
4. The claim will proceed as normal

If your health fund doesn’t have a Digital Health Fund card yet

If your health fund has not yet digitised their membership cards, you will need to bring your physical health fund card to your appointment in order to make a claim.  Digital technology is rapidly changing, so in time, more health funds will digitise their health fund cards as well.  Please check your health funds website for more information on when a digital card might become available.

Understanding how much benefit your health insurer will pay towards your dental treatment gives you an idea of how much you may need to pay out-of-pocket.

To find out your remaining benefit limits, you can call your health fund and ask simply ask ‘How much benefit do I have remaining?’, or you may be able to find limited information via your health fund app on your smart phone.  Depending on which level of cover you are on, and which health fund you are with, your limits may be split between:

• General Dental (check ups and cleans),
• Preventative Dental (fillings and fissure sealants) and
• Major Dental (includes extractions, gum treatment, crowns, root canal treatment, implants)

For a specific quote / estimate on the benefit your health insurer will pay towards your treatment, you will need to provide them with the following information:

1. Your name and member number
2. The Provider Number
   1. This is a 6 digit number that identifies the dentist
3. Treatment ID / Item Number
   1. This is a 3 digit number, usually before the treatment description
4. Tooth ID / Number
   1. This is required for treatment specific to a tooth such as a filling, crown, root canal treatment or extraction
5. Treatment Price

The above information can be obtained from your treatment plan. Without a treatment plan or undertaking an examination, it is difficult to know what treatment you need, and the item numbers to provide to the health fund.

When obtaining a quote /  estimate from your health insurer, please note that if anything changes in relation to your policy, claims you have made to date or when your benefits expire, your quote / estimate will also change.

Due to privacy reasons, our staff are not able to speak to your health insurer without your authorisation to do so first.

To make a claim from your health insurer in our clinics,

1. Bring your current health fund card to your appointment
2. At the end of the treatment, our receptionist will swipe your card through the HICAPS terminal.
3. Details of your treatment will be sent directly to your health insurer and it will be processed instantly on the spot.