Dental Insurance Articles
How Dental Insurance Claims Are Processed By A Company
2010-09-05
There are many dental plans available depending on an individual or family's dental needs. When a person obtains a dental insurance quote, it is important to ask certain questions. You should always know what services are covered and how much coverage you are getting. Do the plans have co-pays or deductibles? Does the policy holder pay up front or do they receive a benefit card which they present to their dentist at the time of treatment? Another very important piece of information is to find out exactly how the insurance claims process works. Some companies will directly bill the dentist so that the individual pays their portion at the time the dental services are received and some will require the patient to pay the entire bill and then submit a claims form for reimbursement.
In the first case, there is no need to fill out any claims forms unless a spouse also has dental coverage. Then, the portion that is paid by the patient can be submitted for reimbursement. If an individual must pay the full amount on the spot, then a dental insurance claims form can be printed offline, obtained from the dentist's office, from the employer or from the insurance company.
When filling out this form, it is important to remember to record the policy number, plan number and the policy holder's name. Make sure the form is completed in full or it may be returned, delaying the claims process. The dentist who performed the work may be required to sign the document as well. Any receipts or invoices must accompany the claims form. Insurance companies will usually ask you to send in original copies so make sure to photocopy all forms and keep them in a secure place.
If the patient and a spouse are both insured through two different carriers, then the patient must submit the expenses to their insurance company first. Then, the unpaid portion can be sent in to the spouse's carrier. The same applies if a child needs dental services. The parent whose birthday falls first in the calendar year can submit expenses first and then the second parent can submit the unpaid portion. This process may take quite some time to complete.
It can take several weeks or months to receive a reimbursement from a dental claim. In some cases, a claim may even be denied. This can be for several reasons. Perhaps the services received were eligible for coverage or the forms were not completely properly. To avoid a possible denial of a dental insurance claim, when obtaining a dental insurance quote, you should always ensure that you know exactly what services and treatments are covered and which ones are excluded.