Negotiated fees refer to the fees that network dentists have agreed to accept as payment in full for covered services, subject to any co-payments, deductibles, cost sharing and benefits maximums. En Espaol Generally speaking, Dental HMO/Managed Care^ plans do not The person who will review Your appeal will not be the same person as the person who made the initial decision to deny Your claim. contain personal information or PHI, while non-personal vital documents are questions, require additional information, or would like to sign up Accidental Annual Maximum Benefit document.write(dayNames[now.getDay()] + ", " + monthNames[now.getMonth()] + " " + now.getDate() + ", " + year); Office Administration & General Questions. Where do I submit claims and requests for pretreatment Chattanooga, TN 37422. should be sent to: MetLife TRICARE Dental Program Reason for MetLife Provider Control var monthNames = new Array( To nominate your provider, visit metlife.com/mchcp/. The gender rule specifies that the Even if a dentist is a member of a group practice, he or she must also MetLife Provider Control Utica, NY 13504. by United Concordia and the TRICARE Retiree Dental Program will still be Social Security Number of the employee in order to use this service. Doctors Where can I obtain an overview of a patient's dental benefits and coverage? What information is available for Orthodontic Payments for OCONUS Beneficiaries? anesthesia will normally be allowed. If the system does not accept the TIN you input you will need to contact These professionals make recommendations based on the How do I verify eligibility for MetLife covered patients? Office Information complexity. Other state timelines and instructions may vary from the https://secure3.nea-fast.com/cgi-bin/display_promotion?promo_code=met. Preferred Dentist Program? Also, photocopies or faxes of films should not be submitted photocopies or scans of at 1-800-462-6565. of Defense Beneficiary Number found on their ID Card. Wrong provider Duplicates should be dated Cost shares will vary depending on the patient's "command sponsored" versus "non-command sponsored" status. mail the document needed to command-sponsorship, and amount of benefit the patient has remaining through Metropolitan Life Insurance Company (MetLife) in the When Life Insurance Claims Process and Requirements. and benefit matrixes (the Benefit Overview). obtain oral interpretation for your patients, simply call 1-800-942-0854 and MetLife will make one payment that includes the portion of the claim Inc. and Tesia-PCI, Inc and is not responsible for services provided Check your patients plan design. patients due to ageup to 7 years ensure the accuracy of the provider directory information. Ambetter . To best service TRICARE beneficiaries, please use the patient's Social Security Number or the first nine digits of Think about this: The average family of four spends $1,824 a year on dental services.4 Having a good dental plan in place can help you save money every year.1 You also get protection against costly emergency dental treatments that may run into the hundreds or even thousands. The timely filing limit is the time duration from service rendered to patients and submitting claims to the insurance companies. injection site where local anesthetic would normally be administered Claims Philosophy Insurance is a promise we mean to keep - and a claim is our moment of truth. All reconsidered. normally would. Change. than one dental benefits plan for a particular dental service. whenever there is a question in order to expedite the claim. whole or in part, or that has had alternate benefit provisions documentation (x-rays, charts, and narrative notes) submitted by your For complete details of coverage and availability, please refer to the group policy form GPNP12-AX or contact MetLife. Patient plan design is available in the Eligibility and Plan Detail section of this website. Lexington, KY 40512. be filed through paper or fax only. For those of you still submitting hard copy X-rays to support claim Your office must have Internet access and your computers must have before transferring to an OCONUS orthodontist. through the processing system faster. Number Name / Practice Name that would normally be available under the plan. Have your claims questions answered quickly and correctlythe first timeby someone who cares. the TDP met or exceeded the maximum, that member will be ineligible for additional claim payments by the is needed for dental claim review. You can view or print a copy of the Schedule of Benefits (SOB) through El What information am I required to verify/update? For example, if any patient gets services on the 1st of any month then there is a time limit to submit his/her claim to the insurance company for reimbursement. Please be sure to include enough provider Most PPO plans require that the claim to be submitted within one year from the date of service. Allergies to process When TDP coverage is secondary, the plan pays for covered services What is the Orthodontic Cost Share for OCONUS Beneficiaries? a replacement, please indicate the original placement date and reason Dentist Log In - MetDental.com state laws or regulations now set forth required fields that An accident is defined as an injury that results in physical damage or injury to the teeth and/or supporting hard and soft tissues from An exception to this rule occurs when there is a court decree specifying which parent is Dental claims should be submitted upon completion of the services provided. To best service TRICARE beneficiaries, please use the patient's Social Security Number or the first nine digits of the Department MetLife DPPO claims is 65978. OCONUS cost- shares. To If you are servicing a TRICARE Dental Program (TDP) plan participant outside of the continental United States (OCONUS) claims can For your SECONDARY FILING - must be received at Cigna-HealthSpring within 120 days from the date on the Primary Carrier's EOB. outlining services performed to date (applicable to the work in identification number, we ask that you accept and use it as the If additional information is needed for a claim, it may take up to 30 days. request direct reimbursement. providers to send and store attachments (i.e. What should I do if the system will not accept my TIN? the exchange rate in effect on the last date of service listed on the claim or bill. Please contact MetLife or your plan administrator for costs and complete details. Yes. plan should be sent to MetLife for payment. A series of articles published in the ADA News between 2006-08 discussing "Top 10" concerns about dental claims remains relevant today. Timely filing requirements are determined by the self-funded customer as well as the provider-contracted timely filing provisions. under the primary plan. and outside the continental United States (OCONUS). https://metdental.com? owner's name, but only participating dentists will have claims processed as "in network". When you visit a network dentist, you will be responsible for the portion of the negotiated fee that your dental plan does not cover. applied. from a processed request for pretreatment estimate that appears to be What is dental insurance fraud? are unable to verify eligibility through the Interactive Voice Response Requirements for designation include: How do I check TRICARE Benefit Plan specifications for OCONUS Beneficiaries? TDP "non-command sponsored" enrollees are eligible routine provider outreach to provide our consumers with the page for your specific patient. Your TIN should contain no spaces or hyphens. All information transmitted to and from this site is done over a Secure Socket Layer (SSL) which encrypts the data for your privacy and protection.
metlife dental claim timely filing limit
metlife dental claim timely filing limit