Frequently Asked Questions
How can I get more information?
You can contact our Member Services Department at 1-800-342-5209, M-F,
8am-6pm EST. You may also locate us on the web at www.compbenefits.com for
more information or to find a provider near you.
How does In-network coverage work?
Upon enrolling in the plan, you may seek treatment from any dentist listed
in the network directory. Your dentist will charge specific co-payments for
covered procedures. This means fewer out-of-pocket expenses for you when
using in-network coverage.
What if I seek Out-of-network care?
If you should decide to seek dental services outside of the Dental Access
network of participating dental providers, you would simply receive dental
care from any licensed, practicing dentist. You will pay for the treatment
rendered, complete a claim form and submit the form for direct reimbursement
of approved claims. A fixed dollar amount is reimbursed for each covered
procedure, not to exceed what would have been payable if a Dental Access
participating provider rendered the service. Your responsibility under this
option includes any cost that remains after reimbursement and maximum
benefit limitations.
May I change my provider?
If you need or want to change your in-network provider selection, simply
select another dentist from the provider directory to receive covered
benefits. You are not required to notify CompBenefits of the change in
dentist selection.
What if I need a Specialty Dentist?
Dental Access members may seek treatment from a specialty dentist at any
time without a referral. Certain dental procedures will require the services
of a specialty dentist (i.e. oral surgery, endodontics and periodontics). In
those cases, if you select a participating specialty dentist, you will be
charged the specialty dentists' appropriate co-payment from our Benefit
Schedule.
Who is responsible for filing dental claims?
Members seeking services from an out-of-network dentist will be reimbursed
by CompBenefits according to the Benefit Schedule. Depending on the
out-of-network dentist's policy, you may be required to file your claim for
reimbursement. You will receive timely payment directly from CompBenefits.
When is my benefit year?
"Benefit Year" for the first policy year begins on the Effective Date and
ends on the 31st of December of the same year. Thereafter, the Benefit Year
will be the calendar year.
Office Visit Co-Pay: $5.00
Applies only when Preventive and Diagnostic procedures are performed
| |
In-Network
Patient Pays |
Out-of-Network
Maximum Reimbursement* |
|
| Initial Exam |
No charge |
$32.00 |
|
| X-Rays (Bitewing - single film) |
No charge |
$12.00 |
|
| Semi-Annual Cleaning, Adult |
No charge |
$45.00 |
|
| Sealant - per tooth |
No charge |
$23.00 |
|
| One surface silver filling, primary |
No charge |
$55.00 |
|
| Two surface white filling, anterior |
No charge |
$75.00 |
|
| Single tooth extraction |
No charge |
$65.00 |
|
| Surgical removal of erupted tooth |
No charge |
$110.00 |
|
| Porcelain crown (high noble) |
$372.00 |
$163.00 |
|
| Porcelain bridge (high noble) |
$335.00 |
$163.00 |
|
| One surface inlay, metallic |
$250.00 |
$126.00 |
|
| Molar root canal therapy |
$368.00 |
$143.00 |
|
| Complete upper dentures |
$472.00 |
$132.00 |
|
