Insurance Verification

Dental insurance policies may have an alternate benefit clause, which is “a provision that helps determine how payment will be made when there are several ‘clinically accepted’ dental services that can satisfactorily correct the dental dentition” (Summerford 2013). This clause was also called the Least...

Dentists usually prescribe opioids to patients experiencing dental pain (Metro-Sanchez). While opioids help mitigate this pain, they cause the patients’ bodies to “release a hormone called dopamine. Dopamine causes [them] to feel pleasure, which could lead to addiction” (“Opioids”). Also, some side effects that patients...

Some patients may have to endure waiting periods during which they have no coverage for certain treatments after a set period of time (Araujo 2018). Dental insurance companies utilize waiting periods in order to prevent people from enrolling into their plan, using its benefits for...

Before sending claims for certain treatments, some dental plans need dentists to receive preauthorization, which “provides written advance approval for the planned service, which is generally valid for 60 days” (“Dental Benefits 101: Preauthorization versus predetermination” 2017). Some dental insurance policies may require additional elements...

Some people with PPO plans go to in-network dentists in order to get more coverage. Some of these dentists may change to an out-of-network status by dropping the PPO plan for reasons, such as “the lower negotiated fees required to participate in dental networks” (“Why...

Dentists can use teledentistry, which utilizes “information technology and telecommunications,” to remotely connect them to patients who cannot easily go to their clinics, such as those in rural areas, elderly people in care homes, and children in certain schools (“Teledentistry 101: Everything you need to...

Dental clinics in insurance networks must have reduced prices for some of their procedures due to their contract with the insurer (DeWood 2016). They may have to apply them to noncovered services, depending on their state and insurance company (DeWood 2016). Consequently, dentists could choose...

Larger employers have to provide their employees the opportunity to utilize continuation coverage through the COBRA program at the federal level. Albeit, small employers with “fewer than 20 employees on at least 50% of its business days in the prior calendar year” do not have...