Dental Benefit, Dental Insurance Coverage’s and the Claims Process.
Unless you have a dental HMO plan where most dental services are based on a fee schedule that lays out your cost for the different dental services, (therefore avoiding the claims filling process) you are having to fill out claims forms. Knowing your cost for dental services can be difficult since most PPO and Indemnity plans pay claims based on a percentage up to UCR (Usual, Customary & Reasonable) rates. Your dentist may provide you an estimate based on your plan stated coverage’s but there is no guarantees that will be your total cost.
In order to make sure you know what your cost is going to be have your dentist submit the treatment plan to your insurance company as a quote only before dental services are started. That way the dental insurance company can be able to state what is covered and for what amount. Stopping the guessing game before it starts