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GEHA PPO Pre-Authorization

GEHA PPO Pre-Authorization

The insurance coordinator 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 GEHA PPO Dental insurance. Some patients request a pre-authorization or pre-treatment estimate from GEHA PPO Dental insurance prior to the start of treatment.

After Sunnyvale Dentist Dr. Bhawna Gupta does a thorough examination, he will provide you with one or more treatment plans outlining all of your options. During this appointment you will also have the opportunity to ask questions, discuss your treatment goals, 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 GEHA PPO Dental insurance for pre-authorization. Once processed, the pre-authorization will give you a lot of helpful information about how much benefit coverage you have remaining for the rest of the year, whether your deductible has been met, whether the procedures are a covered benefit and if so, what your out of pocket cost will be, and the amount that GEHA will pay on the claim.

A lot of our patients find this information helpful when planning and scheduling treatment. Pre-authorization is not usually required in most cases and because it takes a few weeks to receive a response may delay treatment. Our insurance coordinator will let you know if GEHA requires that your prescribed treatment be pre-authorized.

Pre-authorizations are not a guarantee of payment. Pre-treatment estimates are valid for a limited amount of time. The expiration date is printed on the estimate. Final payment is determined after the treatment has been completed and the claim has been submitted to the insurance company. All treatment approved by GEHA must be completed while the dental plan is still active.

Many insurance carriers including GEHA PPO Dental 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 GEHA 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 GEHA PPO Dental insurance provider, he will follow the GEHA 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-GEHA PPO Dental provider.

Learn more when you visit Sunnyvale Dental Care. Call Sunnyvale Dentist Dr. Gupta at 408-720-0900 to schedule a consultation today!

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