You go to a dentist, receive dental treatment, and then your dental service provider submits a claim to your dental insurance company to get paid for the services rendered. Most people are aware of this process, but one of the most asked questions is – how long does dental insurance claims take?
The duration of processing a dental claim might vary from state to state but this period usually ranges from anywhere between 15 to 60 days. The article will cover all the information revolving around dental insurance claims and what you should know essentially!
Dental claims procedure
A dental insurance plan is a contract between you and your dental insurance provider which says that you will be liable to pay your premiums and your insurance company will be paying to your dentist/s as per your plan’s coverage.
The following points explain the dental claims procedure in a simplified manner:
- First, you receive treatment from your dentist
- Your dentist submits your claim to your dental insurance company (the claim has all the details of your treatment or services).
- Claim details are verified by your insurer to check their correctness and accuracy. Your insurer also checks if the rendered services are covered by your plan or not!
- After verifying all the details, your insurer pays the claim amount to your dentist as per the coverage available.
- Your insurer sends you the EOB (explanation of benefits) which has all the details about your coverage. An EOB is also called a dental benefits summary that breaks down all the details of your services and coverage.
- If there is anything that’s not covered by your plan, your insurer sends you a final bill. You would be responsible to pay the final bill amount.
A claim is usually processed within two weeks unless your insurance company requires or asks for additional information about your treatment.
What you should know?
- You must be aware of all the details of your dental insurance coverage. It will allow you to know if you are responsible to pay any upfront costs such as copay or coinsurance to your dentist during your visit.
- A claim is submitted either online or by mail. You can check the status of your claim by logging in to your online account. You can check all the details of your plan’s usage.
- If you do not want your dentist to submit your claim, you can also choose to file a dental claim yourself. Simply log in to your insurance plan’s online account, download the claim form, fill in all the required details and documents related to your treatment and submit. You can also mail all the original copies of the documents to your insurer.
- In case you receive treatment outside the U.S., simply ask for a detailed billing statement from the dentist and submit the same along with the claim form to your dental insurance provider. The billing statement would have the details of your treatment, date of service, name, and address of the dentist, etc.
Knowing all the necessary details of your dental insurance plan’ coverage always comes in handy while filing a claim. Your dentist can also help you with all the information you need regarding your claim.
