Dental offices need the right plan administrator for benefits, claims, predeterminations and appeals. Confirm PPO, DHMO, Medicaid or discount-plan routing.
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Make the call count.
Dental offices need the right plan administrator for benefits, claims, predeterminations and appeals. Confirm PPO, DHMO, Medicaid or discount-plan routing.
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Dental plan and subscriber information
CDT codes, tooth numbers, surfaces and planned service dates
Predetermination, claim and attachment references
Questions to resolve
Which plan network and benefit limitations apply?
Are radiographs, narratives or periodontal charts required?
Is this a predetermination or a required authorization?
This is a general administrative checklist, not payer policy or advice about a particular patient. Confirm the current plan instructions.
For healthcare offices
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For the people making the calls
Put payer follow-up on your office’s worklist.
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