Let’s see you visit a dentist either for a regular check-up or to receive dental treatment. Whatever services you receive during your visit, your dentist will submit a claim form to your dental insurance company requesting payment for the services rendered. In simple words, a claim is the formal payment request submitted by your dental service provider to your dental insurer. A dental claim explains the services and procedures provided by your dentist and his team during your visit.
Dental Claim Process
Once your dentist submits the claim to your dental insurance provider, it’ll go through numerous phases of reviews/approvals before you receive the final bill.
Purchasing dental treatment coverage is advisable so that you do not wind up paying for charges on your own or postpone treatment. With a dental plan in place, you will be free of worries of any kind and will be able to focus on receiving high-quality dental care.
What is covered in dental insurance?
Dental insurance policies, unlike medical insurance, have a limited number of covered areas. As a result, it's simple to keep track of which dental procedures are covered and how much each service costs under your dental plan.
Cleanings, oral examinations, x-rays, fluoride, and sealants are among the services and treatments available. Periodontal (gum) care and deep pocket cleanings are examples.
Fillings, crowns, root canals, extractions, oral surgery, and specialty treatments for the gums and teeth (periodontics), the insides of teeth (endodontics), artificial removable teeth (prosthodontics), and braces are among them (orthodontics).
These dental services are reimbursed at varying percentages, often 50%, 70%, 80%, or a flat cost. Each of these procedures should be included separately in your dental plan contract, along with the percentage of coverage or the flat fee cost. The remaining costs will be your responsibility.