The staff at Sunnyvale Dental Care will do their best to give you an accurate estimate of your dental treatment cost. This estimate will be based on a breakdown of benefits received from Cigna PPO. Some patients request a pre-authorization or pre-treatment estimate from Cigna PPO prior to the start of treatment.
After Sunnyvale Dentist Dr. Gupta does a thorough examination, he will provide you with one or more treatment plans outlining all possible treatment options. During this appointment you will also have the opportunity to ask questions and express any concerns that you have regarding your dental health.
The insurance coordinator at Sunnyvale Dental Care will be happy to submit the treatment plan(s) to Cigna PPO for pre-authorization. Once processed, the pre-authorization will tell you how much benefit coverage you have remaining for the rest of the year, whether your deductible has been met, whether the procedure is a covered benefit and if so, what your out of pocket cost will be, and the amount that Cigna will pay on the claim. Many patients find this information helpful when planning and scheduling treatment.
Pre-authorization is not required in most cases and because it takes a few weeks to process, it may delay treatment. Our insurance coordinator will let you know if Cigna requires that your prescribed treatment be pre-authorized. Pre-treatment estimates are also valid for a limited amount of time. The expiration date is printed on the estimate. Pre-authorizations are not a guarantee of payment. Final payment is determined after the treatment has been completed and the claim has been submitted. All treatment approved must be completed while the dental plan is still active.
Many insurance carriers including Cigna PPO suggest that pre-authorizations be done prior to major treatment such as dentures and crowns, or on procedures that exceed $300. A copy of the completed pre-treatment estimate is available to you from Cigna by mail or online, and a copy will also be sent to our office. We will then contact you to schedule your appointment.
Because Sunnyvale Dentist Dr. Gupta is a Cigna PPO Provider, he will follow the Cigna PPO fee schedule when submitting your dental claims which will mean a lower out of pocket cost for you when compared to the cost of treatment from a non-Cigna PPO provider.