Dental Insurance, How do I make sure I do not go over UCR rates when filing dental claims.
I have a PPO dental insurance plan that I get though work. My problem is that the last few times I got hit with what my Insurance Company calls UCR rates. The insurance company told me my dentist is above the going rates in my area for his services. I am really upset that I keep getting hit with an additional billing that I did not think I was going to have.
I did make some phone call to other local dentist that do seem to be less expensive then my last dentist so I am thinking about changing dental office so that I will not have this problem. How do I go about making sure I do not go over UCR rates?
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Posted on Monday, Jun. 21st 2010 1:33 PM | by Dental | in Dental Claims, Dental help, Dental Insurance | 3 Comments »
Wednesday, Jun. 23rd 2010 10:07 AM at 10:07 am
Whether you choice to change your dental office or not does not matter in confirming UCR rates with your dental insurance plan.
Many insurance companies required that you submit a treatment plan before dental services are render so that they can tell you ahead of time what your coverage mount is.
Doing that for all your dental services will avoid you from having any unexpected additional charges. It sounds like to me you have not been doing that. Having your dental work done before confirming your coverages will leave you at risk
Wednesday, Jun. 23rd 2010 10:13 AM at 10:13 am
I have a PPO plan too. Whenever a dental service is going to cost $300.00 or more I submit a claim as a quote only. My dental insurance is good at getting back with me on what amount will be paid out.
This help me know my total cost for the dental services. My dentist will not do this extra work so I have to do it on my own but it is well worth the time. Once I know what my cost is then I make an appointment to have the dental work done.
Tuesday, Jun. 29th 2010 2:26 PM at 2:26 pm
Why is your dentist not having the treatment plan submitted to your dental insurance company prior to any type of dental treatment. I thought that would be standard practice.
My dentist will not do anything more the cleaning or X-rays without first my dental insurance company giving prior approval of the treatment plan. He does not want to get stuck not getting paid so he know better.
I would talk to your dental office and make sure they process your treatment plan first to make sure what is and what is not covered.