CONSULATE
Dental Insurance and Claims Processing – Consulate Dental Plans
When you have either a Dental PPO or an Indemnity dental insurance plan, you need to understand the claims process. Know how your insurance company handles claims and how your dentist files out your claims.
Problems arise when you don’t fully understand your dental insurance and how they pay out claims. It is also essential to know how the dental office will make you pay for your dental care and how they file out dental claims.
Many PPO plans or free choice of dentist plans state they pay a certain percentage for preventive, basic, and major dental services. However, that percentage is usually up to dental companies’ UCR ( Usual, Customary, and Reasonable ) rates. Understanding the insurance company coverages and what UCR rates are is essential. Submitting dental services to the claims department as a quote only before dental work begins is a good idea. That way, you will always know the true cost of the dental services before committing to having it done.
It is equally important to know how the dental office will file your claim. Refrain from assuming that the dentist will not charge you the total amount for the services rendered, thereby having you file the dental claim and wait for return premiums due from the insurance company. What you have to pay when dental care is provided is a mistake often made, and it usually is after the fact, causing many people to be upset.
Ask the dentist what they expect you to pay before starting dental work. Do they file the claims for you, or do you need to file them? Knowing all this will keep you from any unexpected billings and from getting upset with the dental claim process.