BRUSHING UP ON DENTAL CLAIMS
Dental Benefits are one of the most appreciated parts of a group benefit plan. But confusion sometimes arises when it comes time to file a claim. Here are some of the most common questions.
Who's supposed to sign the claim anyway?
Dental claims ask a number of signatures. For prompt processing, make sure you have the right 'autograph' in the right places. The dentist's office must complete the treatment portion of the form and the employee must sign the bottom.
Here's the tricky part: The patient must sign the confirmation of the amount claimed.
On standard forms that's the box on the right hand side, about a third of the way from the top. The insurer wants the person who received the services to confirm they were provided and that the amount charged reflects the work that was done. If the patient is a dependent child, the employees signs this part of the form. If the spouse received the treatment, the spouse's signature is required.
Do I have to mail in a request for an estimate?
Your dentist's office may also call this a 'predetermination of benefits'. Whatever it's called you're looking for confirmation of how much your insurance will pay before work starts. Although claims must be sent in by mail (or submitted electronically directly from the dentist's office), the Chambers Plan accepts faxes requesting dental coverage estimates. This service can save you valuable time when you're anxious to get treatment underway. Your dentist simply completes a claim form, marking it "Estimate", and sends it to the plan any way that suits you, by mail or fax.
How long do I Have to submit a claim?
The Chambers Plan calls for dental claims to be submitted within 12 months of the date services are provided. If someone leaves your company, they have 120 days to send in claims for services they received while still employed by you.
