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Consulate Dental Plans, Dental Insurance and claims processing.

27/07/12 12:02 PM

When you have a either a Dental PPO or a Indemity denta insurance plan it is important for you to
understand the claims process.   Know how your insurance company handles claims and how your dentist files out your claims.

Problems arises when you do not have a clear understanding of your dental insurance and how claims are paid.  As well as when you do not know how the dental office is going to make you pay for your dental care and how they file out claims.

Many PPO plans or free choice of dentist plans state they pay out a certain percentage for preventive, basic and majors services.  However that percentage is still normally up to what the UCR ( Usual, Customary and  Reasonable ) rates are for dental company.  Knowing this is important and it is a good idea to submit dental services to the claims department as a quote only before any dental work is started.  That way you always know your true cost for the dental services before committing to having it done.
It is equally important to know how the dental office is going to file out your claim.  Do not assume that the dentist will not charge  you the full amount for the dental services render.  Making you wait for your refund back from the dental insurance company.

This is a mistake often made and normally it is after the fact. Causing many people to be upset.  Ask the dentist what they expect you to pay before before any dental work is started.  Do they file the claims for you or do you need to file them? Knowing all this ahead of time will keep you from any unexpected billings  and from getting upset with the dental claim process.

 

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