What does my dental insurance really cover?

by Vera
(Escondido, ca)

I have premiere access and i was told by the finance guy in the office that my insurance doesn't pay them anything and I'm being charged the full price including somethings my son doesn't need.

Why do they always say they don't get payment from the insurance when we pay our insurance premiums?

Reply:

Hi Vera, It is possible to know exactly what is covered before you have any treatment done.

You should call your insurance provider and ask for a summary of what charges have been submitted by your dentist and what has been covered and denied. If there are charges that were not covered ask for an explanation.

Most of the time dental patients receive a written explanation of benefits (EOB) every time something is submitted by your dentist. This should happen whether the service is covered or not. If you have not received an EOB from your insurance provider it is possible the treatment was not submitted properly.

You may need to confirm that your dentist did submit the treatment and that they are in-network for your plan.

Going forward, you should confirm that services are covered with your insurance provider before your dental appointment. Then tell your dentist that you want to be informed of anything that is not covered before treatment.

Thanks for writing,
Shelly


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