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(03) 8199 9949

bookings@wintersmiles.au

Health Funds

DENTAL HEALTH FUNDS

Private Health Insurance With Extras Cover

We accept all private health insurance funds and submit claims on the spot through our HICAPS (Health Industry Claims and Payments Service) machine.

Please make sure that you bring your private health insurance card with you to your appointment if you wish to claim a benefit for your dental treatment. We cannot put through an on-the-spot electronic claim for you without the card. Please note that some health insurance membership cards are now available on Apple devices and android phones. For more details, please get in touch with your private health insurer.

DENTAL HEALTH FUNDS

Preferred Provider Status

Dr Winter is  NIB First Choice network provider. 
 
While Eden is not a preferred provider of any of the other private health insurance funds, he is a recognised provider which means that we can accept every health fund but your gap payment will depend on your level of coverage. 
 
Because we are only a preferred provider with one health insurance company, we are pretty much free to put our patients first. This means that you have more options available to you, many of which will save you money in the long run and be of higher quality. 
 
Eden is also able to offer treatment options, which require more skill and a higher level of training and proficiency because he is not tied to many different terms and conditions set by private health insurance companies through their preferred provider agreements. This makes Eden a more knowledgeable, skilled and experienced dentist. 
 
So while not having preferred provider status with all of the major private health insurance funds does mean that your dental treatment may not be “gap free”, it does not necessarily mean that Eden’s provision of high quality care will be expensive. At Winter Smiles we carefully balance our excellent quality with reasonable pricing. As you can appreciate though, discounted dental treatment has the potential to cause issues in the long run so we would encourage you to ask yourself if it is really worth the risk of cutting corners to save money when it comes to your dental health. 
DENTAL HEALTH FUNDS

"To be or not to be" - The Pros and Cons of Being a Preferred Provider

We are often asked if Eden is a preferred provider of the major private health insurers. 
 
Eden has worked extensively in private practices that have been preferred providers and non-preferred providers. This has given him the opportunity to see for himself in detail how the two systems work.
 
One of the most significant observations that Eden has made over the past 19 years of work is that preferred provider dental practices often put themselves in a position where they sacrifice quality and patient care for more new patients and more money. This is due to the nature of the relationship between a preferred provider dental practitioner and the associated private health insurance company.
 
The preferred provider arrangement
preferred provider arrangement is structured through a financial agreement entered into between a dentist and a private health insurance company enabling both to make more money; it is not an acknowledgment of the quality of the dentist.
 
Preferred provider dentists are contracted to private health insurance companies to offer set fee services. In consideration of this, the insurance companies “recommend” the dentist’s dental practice to their policyholders. This agreement/business structure allows the dentist to obtain more patients while the insurance company pays less in benefits to their customers because of how the services and fees are set up.
 
This arrangement biases the dentist towards focusing on quantity over quality and patient care. What often results is cheaper work that requires more visits over time.
 
And what makes things even more unsettling is that many private health insurance companies actually own the dental practices that are preferred providers and refuse to grant preferred provider status to non-owned dental practices. Many health professionals and industry bodies strongly argue that this creates a clear conflict of interest with the insurer holding so much power over their customers’ health care and information whilst making money at every step.
 
The benefits of not being a preferred provider
In addition to the benefits listed above, not being bound by the arbitrary terms and conditions of many different preferred provider agreements means that:
  • You, as a patient, are our first priority (instead of being focused on meeting our obligations to a big private health insurance company). This in turn means that our interests are more aligned with our patients’ interests);
  • Eden will always value his relationship with his patients more than commercial business decisions;
  • Eden can spend more time with you;
  • Eden can produce higher quality work and have a stronger and more diverse experience base.
  • Our patient list grows from word-of-mouth referrals and by providing excellent service and treatment (instead of only seeing new patients who have been directed to us by their private health insurance company).