Dental Insurance Articles
Wading Through The Red Tape Of Dental Insurance Claims
2010-11-16
When wading through the red tape of dental insurance claims, it can look tempting to just give up and self pay for dental services instead of using the benefits from dental insurance plans. But this is a problem that is easily remedied with a thorough understanding of how the dental insurance claims process works. Dental insurance claims, like health insurance claims, follow a fairly standard process that varies only in the usual areas like whether or not the care provider is willing to file insurance claims forms on the patient's behalf, or whether the care provider indicates that this is the patient's responsibility at the time service is provided. Since this will be explained to the patient before services are extended, the patient can prepare for either scenario by contacting their dental insurance provider and finding out how to proceed when it is time to file a claim.
The first step in wading through the red tape of dental insurance claims is to establish who has the responsibility for filing the dental insurance claims. If it is the care provider, nothing further must be done by the patient except for obtaining any necessary pre-authorizations for care to be provided by the dental professional. If the patient is responsible for filing dental insurance claims, the patient must contact the insurance carrier and find out how to proceed. The dental care provider will present the patient with a dental insurance form at the time of the visit, and the patient will include name, contact address, phone number, proof of insurance, and relevant medical history on this form at the time of service. Dental insurance plans also ensure that their customers are aware of how to file a claim by providing a form that is used for claim submissions, and this is always available to the patient through mail or for download from the carrier's website. The patient then requests this additional form, completes it, attaches the description of services provided and receipt showing proof of payment, includes the policy number on the form, makes a copy for their own personal records in the case the form does not safely reach its destination for any reason, and then submits it to the insurance company for reimbursement.
Once the patient has completed their part of the dental claims submission process, the next step is to wait for the dental insurance carrier to review the claim and make a determination. This process can take a few weeks to complete, and the insured should not hesitate to call the dental insurance carrier should there be a question about where their claim is in the determination process. This ensures dental insurance claims go smoothly.