What is a pre-determination of benefits for dental and when do I need one?
A pre-determination of benefits is an 'estimate' of what your dental insurance plan will cover for a specific dental procedure.
If you are unsure whether a particular dental procedure will be covered, or if a proposed course of treatment is expected to cost more than $500, it is advisable to have your dentist’s office submit a pre-determination of benefits to the insurance company before the procedure. To submit this information, your dentist will need your Plan Number and ID number.
The insurance company will review the submission and reply with a written letter clarifying the amounts (if any) covered by your plan.
This way, you can make an informed decision about how to proceed with your dental treatment.
If you are unsure whether a particular dental procedure will be covered, or if a proposed course of treatment is expected to cost more than $500, it is advisable to have your dentist’s office submit a pre-determination of benefits to the insurance company before the procedure. To submit this information, your dentist will need your Plan Number and ID number.
The insurance company will review the submission and reply with a written letter clarifying the amounts (if any) covered by your plan.
This way, you can make an informed decision about how to proceed with your dental treatment.