Insurance & ACC Information

Medical Health Insurance

Elligibility

Most Oral & Maxillofacial Surgery is classified as a “Surgical or Medical” problem and is often covered by Medical health insurance. You do not need separate dental cover.

As a general guide; your initial consultation and any x-rays are usually covered by health insurance, once you have decided on treatment you then apply to your insurance company for prior approval, often this is done by just a phone call.

Wayne is an affiliated provider for Southern Cross Healthcare, this means you do not need to do any paperwork for your consultation or X-rays. Just bring your health insurance number with you and the transaction is performed electronically at the appointment without need for forms / prior approval or waiting on hold on the telephone.

Prior Approval

Wayne will provide you with a written estimate of costs for the proposed treatment. The easiest way to apply for prior approval is online or by phone, your insurance documentation will have all the details. Occasionally Wayne will need to correspond with your insurer which usually takes 1-3 days, if you have not heard from your insurer within the week of applying then contact them to see if there is a problem or if they are waiting on more information. Complete payment for services is requested at the time of surgery, unless you have a pre-approval letter from your insurer, please show the letter to the Front Office Staff and they will provide you with an invoice to send to your insurer.

Completing Your Claim

If you have had treatment under General Anaesthetic at Boulcott Hosptial then you will receive 3 invoices, from your Anaesthetist, Boulcott Hospital and Wayne. Wait until all three arrive and send these to your insurer with a completed claim form. Also include any related costs to you, such as the initial consultation, x-rays and prescription medicine costs. Your insurer will pay the invoices directly.

Our staff are familiar with the insurance claim process, if you have any questions then contact the front office or talk with Wayne about this at your consultation or follow up.Each insurance company has a slightly different process.

Please call if you have any questions or concerns regarding your initial visit.

ACC – Accident Compensation Corporation

If you have had an injury which is registered with ACC then you will be elligible for assistance from ACC. The costs of treatment are part paid by ACC and you will have this clearly documented prior to deciding on treatment.

As a guide:

ACC Consultations and X-rays have a part charge paid by you of $0 – $30

ACC Dental Implants are fully covered. There may be a part charge from your dentist for the final crown.

ACC Apicectomy approx part charge $500 – $650

Most intermediate or major Surgery requiring General Anaesthetic is fully covered.