Because of the complexities surrounding many dental insurance policies, some patients request a pretreatment estimate or pre-authorization of benefits prior to receiving restorative dental care. This is not a requirement for most procedures on the DenteMax PPO insurance plan, but the Sunnyvale Dental care team is happy to provide this service for their patients. X-rays, periodontal (gum) measurements, photos and other documentation may be required by DenteMax PPO insurance to process the pre-authorization. The Sunnyvale Dental care insurance coordinator will make sure that this information is included.
During your initial exam, you will be able to discuss your treatment goals with Sunnyvale Dentist Dr. Gupta. With your goals and dental condition in mind, he will create a treatment plan. Dr. Gupta will give you an estimate of how long it will take to complete your treatment plan.
It may take a few weeks to receive a response from DenteMax PPO insurance regarding your pre-authorization. Once received, your treatment can proceed. The form will have a disclaimer stating that it is not a guarantee of coverage. The final coverage amount will be determined once the treatment has been completed. However, pretreatment estimates can give you a fairly accurate assessment of what DenteMax PPO insurance will pay on your behalf if your premium payments remain current.
The pretreatment estimate is valid for a limited amount of time, so you will want to be sure to schedule your treatment in a timely manner. The pre-treatment estimate may include the amount that you are saving by completing your dental treatment with a DenteMax preferred provider like Sunnyvale Dentist Dr. Gupta.
Other information provided on the pre-authorization form will be the amount that you have available to use for the year and your annual deductible information. The amount that DenteMax will pay for each covered service on the treatment plan will be listed, as well as the estimated patient portion. If your treatment plan exceeds your yearly maximum allowance, it may be possible to finish your dental care when your policy renews. Many dental insurance plans run from January to December. Whether or not you have a calendar year plan will be verified in advance.