The Ins and Outs of Filing Dental Claims (Insurance Submission Tips)

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Now that you have some of the information needed to truly understand your insurance coverage now here are some tips to help insure your dentist/dental office will be able to file your claims effortlessly.

Providing the following information will assure a prompt submission of your dental claim(s):

  • Insured’s name
  • Insured’s birth date
  • Insured’s address
  • Relationship to the patient
  • Insurance ID card or insurance name, address, telephone number & group number

Because of rise identity (ID) theft these days, some insurance providers assign each subscriber an unique ID number.  If you are afraid of being a victim of ID theft or have been a victim of ID theft you may want to only provide this number to your dental office.  However, keep in mind some insurance companies will continue to use your social security number as a means of finding you in their system.    Other tips to remember:

If coverage is provided by two insurance carriers, please provide the exact same information as listed above to your dentist/dental office for both insurance carriers.

Dependents in college may need to provide the dentist/dental office with a copy of their college ID or copy of transcripts as proof of being a full time student before coverage is authorized.

In cases of  separate households, please provide the dentist/dental office with the address of which household the child(ren) reside in.  In the case of two insurances, the primary carrier will be the one where the child lives, unless otherwise specified in a divorce decree.

If there are 2 insurance carriers, most companies make the determination of who’s going to be the Primary (1st) carrier according to the Birthday rule.  This simply means whomever’s birthday falls first on the calendar (not the one born 1st – years do come into play here, sorry).  Some other insurance carriers continue to follow the gender rule, male (1st), female (2nd).  Also if an individual has 2 insurances for themselves, the insurance purchased first is considered the primary carrier.

Filing time:

Keep in mind most insurance claims MUST BE filed within 1 year of the procedure being done, some policies you only have 6 months.  It can be one day late, and believe me, it will be denied.  So check the filing time for your dental claims.

Roxie

We are passionate about promoting healthy, white smiles and hope you are too! What to know how to maintain and beautiful smile? That is what we are here to help you with!

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