Health funds, CDBS and DVA.

What preferred provider means

We are a preferred provider for HBF, Medibank, nib, HCF and CBHS. A preferred provider arrangement is an agreement between a dental practice and a health fund. For members of that fund, it can mean a higher rebate or a lower out‑of‑pocket cost on some items, although the details differ between funds and between policies within the same fund.

The arrangement doesn’t change how we decide on treatment. Your dentist recommends what suits your mouth, and the fund agreement only affects how the cost is shared. If you belong to a different fund, you can still claim with us; the rebate is set by your fund and your level of cover.

Claiming at the desk with HICAPS

HICAPS is the electronic claiming system most Australian health funds use. At the end of your appointment, your health fund card goes through our terminal, the claim is sent straight to your fund and the rebate comes off your bill. There is nothing to post and no waiting for a refund to reach your account.

A few things can stop a claim going through on the day: leaving your card at home, a card that has expired or been replaced, or a policy that is still within a waiting period for that service. If that happens, we can give you an itemised account, and most funds let you claim later through their app or website.

Reading your extras cover

Dental benefits come from the extras part of a private health insurance policy, sometimes called general treatment or ancillary cover. Hospital cover on its own doesn’t usually pay for treatment in the dental chair. Most extras policies split dental services into categories:

• General dental (sometimes called preventative or basic dental): usually check‑ups, cleans, x‑rays, fluoride, fissure sealants, simple fillings and straightforward extractions.
• Major dental: usually more involved work such as crowns, bridges, dentures, root canal treatment, surgical extractions and, on some policies, implants.
• Orthodontics: often a separate category with its own waiting period and limits.

Waiting periods and annual limits

Two other parts of your policy affect what you get back. Waiting periods are how long you need to hold cover before you can claim. They are often shorter for general dental than for major dental, which commonly carries a waiting period of around 12 months, but this varies between funds and policies.

Annual limits cap how much your fund will pay for a category in a year. Depending on your fund, that year may run from January or from the date you joined, and some policies also have per‑item or lifetime limits. Because policies differ so much, your fund is the only one who can tell you exactly what you will receive, and checking before a larger course of treatment helps avoid surprises.

Written estimates before treatment

Before planned treatment begins, we give you a written estimate listing each proposed service with its item number and fee. You can take it home, compare it with your policy and ask us questions before deciding.

An estimate reflects what we can see and plan at the time. Occasionally the plan changes once treatment starts, for example if decay turns out to be deeper than it looked on the x‑ray. If that happens, we pause, explain what we have found and update the estimate before going further.

Item numbers, explained

Every dental service in Australia has a three-digit item number from the Australian Schedule of Dental Services and Glossary, published by the Australian Dental Association. Health funds use these numbers to work out which rebate applies, so quoting them is the clearest way to ask what you will get back. A few common examples:

• 011 is a comprehensive oral examination: the thorough check usually done at a first visit or after a long gap.
• 114 is the removal of calculus, the hardened deposits taken off during the scale part of a scale and clean.
• 531 is a tooth-coloured filling on one surface of a back tooth. Fillings that cover more surfaces, or front teeth, use other numbers in the same group.

Child Dental Benefits Schedule (CDBS)

The Child Dental Benefits Schedule is a Medicare program for basic dental care, and our children’s dentistry page explains what early visits involve. Children aged 0 to 17 may be eligible if they are eligible for Medicare and they, or their family, receive Family Tax Benefit Part A or certain other government payments.

Eligible children have a capped benefit that can be used across two consecutive calendar years. It covers services such as examinations, x‑rays, cleaning, fissure sealants, fillings, root canal treatment and extractions. Orthodontics, cosmetic dentistry and treatment in hospital are not covered.

Medicare requires us to explain the proposed services and costs and to have a parent or guardian sign a consent form before CDBS treatment begins. You can check eligibility and the remaining balance through your Medicare online account in myGov.

DVA Gold and White Card holders

Veterans and eligible family members holding a Department of Veterans’ Affairs Gold Card or White Card are welcome here.

Gold Card holders are generally covered for clinically necessary dental care within DVA’s fee schedule and limits, and some services need DVA approval first. White Card holders are generally covered only for dental treatment related to an accepted condition. Bring your card to every appointment, and where approval is needed, we will explain the process before that part of your treatment goes ahead.

If you don’t have private cover

Plenty of people don’t have extras cover, and you don’t need it to be a patient here. You receive the same written estimate, so the cost is clear before you decide.

If cost is a worry, tell your dentist. It is often possible to prioritise, deal with anything urgent first and plan the rest over time. Keeping up with check‑ups and cleans can also help pick up problems while they are smaller and simpler to fix. If you hold a concession card, you may also be eligible for public dental care through the WA Government’s dental health services.