Dental Insurance Articles
Items That Will Be Rejected On A Dental Insurance Claim
2010-11-16
A dental insurance policy is one that is separate and distinct from a health insurance policy, and can be used to cover everything from standard checkups to more complicated dental procedures. Just as with health and car insurance, dental insurance has made the move to providing quotes and services online, giving Americans more choice than ever when it comes to their dental health. Just as with all insurance services, however, the largest issue that most consumers face comes when they must make an insurance claim. Rejected claims can be a source of great frustration for consumers, and knowing what will be rejected on a dental insurance claim is worth knowing before a claim is submitted and not paid for.
On a dental insurance policy, commonly covered items include things that are regular and recurring. This covers once or twice yearly dental visits and cleanings, along with the use of fluoride and the possibility of fillings. In addition, most plans will have some coverage built-in for procedures such as root canals and crowns, as well as more intensive dental surgery. Even X-rays may be covered, depending on the type of plan purchased. However, there are number of items that most plans will not cover, chief among them braces. While some portion of their cost may be covered, the attachment and fitting of braces will usually require a specialist who may not be a part of the dental health network. In addition, large dental surgeries will only be partially covered, and depending on your agreement with your provider, may come with a large co-payment or deductible before the insurance company will begin to pay.
Other common items that result in rejected claims are things like extra check-ups or polishing. Most plans will set out how many times per year they will cover teeth cleaning or check-ups, and any others will be at the cost of the patient alone. As well, patients must be careful to follow the procedures laid out by their dental insurance policy. Not filing the correct forms and not filing them on time will result in a claim being denied, and there will be little that can be done to appeal if you have not followed the requested procedures. Ensure to keep and submit all forms that you receive, and if the dental office says they will do it for you, obtain a copy for your own records.
Knowing what to expect when claiming a dental procedure will help to make the claim less stressful, and knowing what exemptions exist will mean less rejected claims and less time spent fighting with the insurance company instead of getting your procedures paid for.