TriCare Delta Dental Pre-Authorization

TriCare Delta Dental insurance does not require that most dental procedures have advance approval, but your Sunnyvale Dentist Dr. Gupta’ treatment coordinator will submit a pre-authorization of benefits to TriCare Delta Dental if you request it. Despite the delay in treatment, there certainly are advantages to receiving this information.

Receiving an unexpected bill can be an unpleasant surprise. Pre-authorizing items on a treatment plan with TriCare Delta Dental insurance can help lessen the possibility of an unexpected balance for its members. Sunnyvale Dentist Dr. Gupta will thoroughly examine your teeth and advise you of any necessary treatment. The Sunnyvale Dental Care insurance coordinator will send the treatment plan to TriCare Delta Dental insurance along with any x-rays, photos, or supporting documentation that they require. It may take two or more weeks to process the pre-treatment estimate. Once the pre-authorization has been processed and approved, it will be mailed back to Sunnyvale Dental Care. We will then contact you to explain the estimate and schedule your treatment. A copy will also be provided for you upon request.

What type of information can you expect to see on your pre-authorization of benefits? Before your first visit we will already have benefit information for your plan including a breakdown of coverage and benefits. The pre-treatment estimate will show the yearly benefit amount that is yet unused. If you have an annual deductible, it will state the amount and if it has been met. Deductibles may range from $25 to $100 a year per person.

Most insurance companies cover procedures on a percentage basis under the categories of preventative, basic, and major. The pre-authorization of benefits will show which category each item on the treatment plan falls under, and at what percentage it will be covered. The dollar amount that you can expect to be paid by TriCare Delta Dental on your behalf as well as your estimated patient portion will be included. You may also see the amount that you saved by scheduling your dental treatment with a provider who participates in the reduced fee TriCare Delta Dental network like Dr. Gupta.