Option III - Elite Preferred Plan Frequently Asked Questions
How do I select an In-Network dentist?
You may choose a participating In-Network general dentist from a
Preferred Provider directory. In-Network participating dentists are
conveniently located near your home or office. CompBenefits carefully
reviews the credentials of each dentist before they are selected to join
the CompBenefits network. By using an In-Network dentist, you will receive
maximum benefits.
How do I select an Out-of-Network dentist?
If you prefer to choose a general dentist not listed in the Preferred
Provider directory, you will be using an Out-of-Network dentist. You will
be charged the dentist's usual and customary fees for treatment received.
When you use an Out-of-Network dentist, your out of pocket costs will
typically be greater than if you use an In-Network dentist.
How does my bill get paid?
Billing is dentist specific. The dentist may agree to file your
insurance claim for you. However, if he/she does not, you may be required
to pay the entire bill at the time services are rendered and will,
therefore, need to submit a claim to CompBenefits for reimbursement. Your
reimbursement will be based on whether you have used an In-Network or
Out-of-Network dentist, and also whether or not you have met any
applicable deductible or coinsurance amounts. Again, all financial
arrangements concerning payment for services rendered are strictly between
you and your dentist and should be determined prior to the start of
treatment.
What are usual and customary charges?
Usual and Customary Charges (UCR) are those fees normally charged by
the dentist for a given service or treatment.
When is a predetermination needed?
If a planned treatment is going to cost over $300, you should ask the
dentist to file for predetermination of benefits before services begin.
Predetermination is not necessary for emergency treatment.
