An unexpected gift or visit from a loved one is a pleasant surprise. An unexpected bill is a very unpleasant surprise. How can you limit your chance of receiving an unexpected dental bill? Pre-authorization or predetermination of benefits can help.
Sunnyvale Dentist Dr. Antonious is an in network provider for Humana Dental PPO insurance. When you provide the id number and date of birth for the Humana Dental PPO subscriber of your insurance policy, the Sunnyvale Dental Care front office staff can request pre-authorization for items in your dental treatment plan.
How will Sunnyvale Dentist Dr. Antonious determine what to include on your treatment plan? During your initial examination Dr. Antonious will use x-rays and other diagnostic tools to evaluate your teeth and periodontal (bone and gum tissue) health. Your treatment plan may include procedures to remove decay, treat infection, rebuild missing tooth structures, replace missing teeth, or improve the health of your gums.
The treatment plan will then be given to the Sunnyvale Dental Care insurance coordinator who will submit it along with any supporting documentation to Humana Dental PPO insurance. It may take several weeks for Humana Dental PPO insurance to process the pre-authorization. Once it is received you will be able to plan for your upcoming appointments.
What type of information can you expect to find on the pre-authorization? The pre-authorization or pretreatment estimate will state whether or not the proposed treatment is a covered benefit of your plan. If it is covered, you will see the percentage of coverage that you can expect to be paid on your behalf along with the dollar amount. Your estimated copay will also be included. The remaining amount of your annual maximum and your deductible will also be shown.
It will be important to note the expiration date for the pre-authorization. Be sure to complete all approved treatment while the insurance policy is still active to receive coverage. The pre-authorization is not a guarantee of coverage but will provide a good idea of what to expect your insurance to pay on your behalf.