Insurance Info

Does My Dental Coverage Cover OMT?

There are three ways to determine if your dental coverage covers OMT:

1. Check the Chart

The chart below serves as a quick reference to see which codes are typically covered by common plans. Although the chart may show potential coverage for a particular code, this does not guarantee coverage by your plan, as it depends on each individual plan. This chart also does not show the dollar amount that is typically covered, only whether or not there could be any coverage. Code 05012 is the code that is most commonly billed throughout our programs, but is only covered by Sun Life.

2. Request a Pre-Auth

Send an email to reception@pearlomt.ca with subject heading “Pre-Auth Document Request” and mention which insurance company/companies you would like to send a pre-auth to. Once you have received the document from us, you can add your personal information and submit this digitally in your insurance account or mail it to your insurance company claims office. Some insurance companies can take approximately four months to produce a response.

It is rare for insurance companies to share information with us. If we receive any communication from your insurance, we will notify you.

3. Call the Insurance Company

You can simply call and ask if the codes in the above chart are covered by your plan. Some insurance companies are not willing to share this information with you over the phone but this is a much faster way that sending a pre-authorization.

Claiming Dental Insurance Coverage

Speech Language Pathology Coverage

Orofacial myofunctional therapy can also be covered under speech language pathology coverage. For this type of coverage, the treatment would need to be performed by a speech language therapy office that provides myofunctional therapy as a service. We do not have speech pathologists on staff at our clinic because we are a dental hygiene clinic.