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PPO EP705 Frequently Asked Questions The PPO EP705 dental plan provides a wide variety of benefits. With this plan, you are responsible for the difference between the dentist charges and the plan Schedule of Benefits. The plan features:
Elite 705 is a PPO Plan that allows you to use any dentist or specialist, including a CompBenefits Participating PPO dentist, and be reimbursed for covered services according to the Plan's Schedule of Benefits. Enhanced benefits are available with a PPO Dentist. How do I obtain a listing of Participating PPO Providers? You can obtain a listing of participating PPO Providers including General Dentist and Specialists (Endodontist, Orthodontist, Oral Surgeon, Pediatric Dentist, Periodontist, and Prosthodontist) through this website's - Search for Providers or by contacting our Member Services Department at 800-342-5209. How do I select a Participating PPO dentist? You can select a participating PPO dentist from the CompBenefits Provider Directory. By using a participating PPO dentist, you will receive maximum benefits since participating PPO dentists have agreed to discounted fees. The CompBenefits PPO Provider Directory is subject to change at any time with or without notice and may not be available in all areas. What if I select a Non-Participating PPO dentist? If you prefer to choose a dentist not listed in the CompBenefits Provider Directory, you will be charged the dentist's usual and customary fees for treatment received, instead of the discounted fees. When you use a non-participating dentist, your out-of-pocket costs will be greater than if you use a participating PPO dentist. How can I control my out-of-pocket costs? By choosing a Participating PPO dentist and receiving additional savings on your out of pocket costs. How many times a year can I visit the dentist? You are encouraged to visit your dentist regularly. With your CompBenefits dental plan, you are not limited to a specific number of visits per year. However, some benefits do have frequency limitations. Please review the schedule of benefits for additional information. How can I get more information? You can contact our Member Services Department at 800-342-5209, M-F, 8am-6pm EST. Member Services can assist you with information about your plan, provide a listing of CompBenefits PPO Providers, and assist you with any claim questions. How do I make appointments? Making an appointment is easy. Simply call a CompBenefits PPO provider or any dentist to schedule an appointment. The dental office can confirm your coverage by contacting our Member Services Department at 800-342-5209.How does my bill get paid? Both participating and non-participating dentists may agree to file your insurance claim for you. However, if they do not, you may be required to pay the entire bill at the time services are rendered by the dentist. You will then be responsible for submitting a claim to CompBenefits for reimbursement. Your claim will be paid based on your Schedule of Benefits. Benefits will be payable after your deductible (if applicable) are satisfied. Your plan also has an annual limit on benefits available. What is a predetermination/pretreatment estimate? By submitting a predetermination/pretreatment estimate claim form, CompBenefits will notify you and your dentist of the benefits payable based upon the planned dental treatment. When is a predetermination needed? If a planned treatment is going to cost over $300, you should ask the dentist to file for a predetermination of benefits before services begin. Predetermination is not necessary for emergency treatment. Where should I send my claim form for actual services or predetermination/pretreatment estimate? Dental claims forms can be printed from this website or you can contact our Member Services Department at 800-342-5209. Please send all dental claim forms to: CompBenefits Claims Are there any exclusions or limitations under this plan? Please refer to the Schedule of Benefits for plan exclusions and limitations.
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