

PPO 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 $200, you should ask the
dentist to file for predetermination of benefits before services begin.
Predetermination is not necessary for emergency treatment.
How can I get further questions answered?
You may contact CompBenefits with any questions or concerns at
1-800-342-5209, M-F 8 am - 6 pm EST. Locate us on the web at
http://www.compbenefits.com.
|