What a cost estimate is
A dental cost estimate, in short KVA (Kostenvoranschlag), is a written document prepared before treatment begins. It lists all planned services with the associated positions from the Swiss SSO dental tariff. Materials and lab costs are itemized separately. The total at the end is the calculated treatment sum.
The cost estimate has two functions: First, it is a transparent decision basis for you. You see what the treatment costs in which constellation before you agree. Second, it is the document you submit to your health insurance or supplementary insurance to check cost coverage.
What is in the cost estimate
A complete cost estimate contains the following elements:
Diagnosis. What was found and which treatment is derived from it.
Tariff positions. Each individual service is listed with a position from the SSO tariff. For example “4060 root canal preparation per canal” or “4910 simple implant surgery”. Per position the number of tax points is given.
Tax point value. The monetary amount per tax point is not fixed in Switzerland but differs depending on insurance status. For self-payers the tax point value is typically one franc but can deviate. Privately insured or certain tariffs have higher values.
Material costs. Implant screws, crown material, membranes for bone augmentation and similar materials are listed separately.
Lab costs. Crowns, bridges and dentures are fabricated by the external lab. The lab costs are added to the dental service.
Sedation or anesthesia. If necessary or desired, the sedation service is itemized.
Total and interim calculation. Some treatments are billed over multiple sessions. The cost estimate shows the total over all sessions plus the amounts per phase.
When a cost estimate is prepared
Swiss consumer law and the professional ethics of SSO provide for a written cost estimate with larger treatments. The exact threshold is not legally fixed but a practice standard. Most practices, including Resident, prepare a cost estimate for treatments from about CHF 500 to 1,000 total costs.
With smaller treatments such as a single filling, a routine check-up or a dental hygiene session, the receipt is usually prepared directly after treatment. You pay on site or receive the invoice by mail.
With elaborate treatments such as implants, multi-part prosthetics, orthodontic therapies or root canal treatments the cost estimate is mandatory and is discussed before treatment begins.
How you submit the cost estimate to health insurance
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Keep cost estimate in copy. Resident sends you the cost estimate digitally or by mail. You keep the original.
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Check justification letter. If the treatment possibly falls under one of the KVG categories (consequence of a systemic disease, accident, severe disease of the masticatory system), we write on request a justification letter with medical diagnosis explanation. For pure self-pay treatments with supplementary insurance this is usually not necessary.
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Submit to insurance. With health insurance and supplementary insurance submit separately. Processing time is two to six weeks.
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Await written answer. You receive a cost confirmation or refusal. With confirmation the reimbursement quota and the maximum reimbursed amount is named.
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Begin treatment. Only after written confirmation or conscious self-pay decision. Resident awaits the insurance’s answer if you wish.
More background on insurance logic in the article on health insurance at the dentist.
How to read a cost estimate
The SSO tariff numbers appear cryptic at first glance. They follow a uniform logic:
- Four-digit numbers like 4060, 4910, 4061
- Description of the service in plain text beside
- Number of tax points per position
- Multiplier (count) when billed multiple times, e.g. three root canals with a posterior tooth
- Subtotal per position
If you do not understand individual positions, ask. Resident staff explains the cost estimate in detail. A rough rule: diagnostics and consultation are moderate. Surgical procedures and implant materials make up the largest part of larger invoices.
What happens when the cost estimate is exceeded
As a rule: the cost estimate is binding as long as no medically unforeseeable complications occur. When during treatment additional measures become necessary (e.g. bone augmentation that was not planned before), we inform you before the extension. You decide whether the additional measure is done.
With substantial overshooting you receive an additional cost estimate that you can subsequently submit to the insurance. The insurance checks the additional service separately.
A small deviation in the range of a few percent is common, for example because the material consumption was slightly above the estimate. A substantial overshooting is transparently communicated.
How Resident prepares cost estimates
We prepare the cost estimate after diagnostics, that is, after assessment, X-ray and possibly CBCT image or intraoral scan. Earlier the cost estimate would be speculative.
You receive the cost estimate digitally by email or upon request by mail. In the initial consultation or a follow-up appointment we go through the cost estimate together and explain every position. If you want to compare two treatment options (e.g. implant versus bridge), we prepare two cost estimates for comparison on request. More on this in the article Implant or bridge.
With financial questions or preference for installment payment we address the options openly. We do not pursue a treatment recommendation that you cannot or do not want to afford. With smaller budgets there are often alternative solutions that we discuss together.
Using the cost estimate as decision basis
The cost estimate is not only an insurance document but a decision basis. With the cost estimate in hand you can:
- Think about the treatment again in peace
- Get a second opinion if you are unsure
- Check the reimbursement quota at the insurance
- Cleanly separate own share and insurance share
- Compare the cost estimate with other practices if you want a price reference
Resident has no objections to second opinions or price comparisons. We want you to begin a treatment not from pressure but from informed conviction. Arrange an appointment for an initial consultation online via the booking widget of your location or by phone.