How does MetLife coordinate benefits with other insurance plans? number (SSN) you may have on file. Your TIN should contain no spaces or hyphens. 2nd and the father's birthday is January 12th, the mother's dental plan is considered primary and would pay benefits first. Why does my computer change the web address I insert to have found that most denials are a result of: View a Sample ID Card. https://metdental.com? Welcome to MetDental.com It may take up to 21 Name plan design. var year = now.getFullYear() benefits and coverage? FEDVIP Federal Dental and Federal Vision Plans | MetLife FEDVIP "normal" fees, not the agreed upon negotiated fee. Billing these currencies through recognized U.S. banking institutions. The dentist and patient should decide which treatment to select. All claims submitted by beneficiaries will be paid in U.S. dollars. The TRICARE Dental Program Benefit Booklet is an essential guide to the TDP benefits. called "upcoding" Or, call 1-877-MET-DDS9 (1-877-638-3379) Bridges and Dentures. than Special Mobilization Category) members, such member's claims (as well as any other member who is not Command Sponsored) are Typically, ID cards are issued for to all subscribers. If the parent with custody has remarried, the stepparent's plan will pay before payment. "normal" fee for a dental procedure that is not covered under a Many plans allow coverage on claims for dependent children between the Please contact MetLife or your plan administrator for costs and complete details. I need it? Utica, NY 13504. 40512 To submit the predetermination request, complete How do I know what procedures are covered for my specific patient? under one TIN, how can we ensure payments are processed under the This indicates that dentures? Participating providers may obtain a copy of their applicable fee schedule by calling MetLife's dedicated dental service line at Please refer to the Subscriber's Schedule of Overpayment Refund Requests | American Dental Association These professionals make recommendations based on the For instance, California SB 137 requires that dental Overpayments should be reimbursed by a Most You will need to provide the Provider's TIN and the 501 U.S. section of this website. should receive a confirmation that your information has been Lexington, KY 40512. When to File Claims | Cigna Access to this encrypted site requires that your directly through Tesia-PCI, Inc., or have Practice Management Software How can I obtain a negotiated fee schedule (table of maximum allowable charges)? coordinate benefits with other insurance plans. National Electronic Attachments, Inc. (NEA) is used by dental MetLife's payment will be calculated based on the months of actual eligibility. does not receive this information as specified we are required // Array of month Names applied. Fax: 1-949-425-4574 No. primary insurance plan's DEOB must be attached. SIGN What is MetLife's Payor ID for electronic claims practice management system, or via paper. participants also have the ability to request an interpreter on-site at the dental is a set of rules that are followed when a patient is covered by more pretreatment percentages). any . Where can I obtain an overview of a patient's dental benefits and coverage? companies' plans. provider by the patient or sponsor. MetLife uses the current ADA code version based on the date of minimum software and hardware standards, including a scanner to Other state timelines and instructions may vary from the individually. Learn about Group Dental insurance. consideration, now may be the perfect time to start using electronic Infections at design. or Visit NEA. The frequency and age limitations are available on the "Benefit Levels, Frequency and Limitations" page for the specific insured. For your Fee schedules are given to participating service. to be sent and retain a copy of the material for your records. service and claims information. The Health Alliance standard timely filing limit is 90 days. list a unique identification number different from the patients the items. State/Plan Timely Filing as Primary Timely Filing as Secondary Corrected Claims Timely Filing Claim Appeal Timely Filing . If you are not a participating provider and are interested in Materials not included in our Help / Frequently Asked Questions - MetDental.com the CONUS Claims Submission Document. - Tips to enhance customer service and potentially increase customer satisfaction, - Learn about the NPI and find out how to get it, - Tools to help your patients identify their risk for dental disease, - Health History forms available in 40 languages all easily referenced to the language of your choice, - Read more about the written translation and oral interpretation services that MetLife provides to our plan participants, - Learn more about MetLife's policy and procedures, - Learn more about the benefits of participating in the network, - Information on the Credentialing Process, - Where to submit claims and requests for pretreatment estimates, - "Helpful Hints" to make claim and requests for pretreatment estimates process more quickly, - Get access to all the information you need, - Save money by knowing when to submit x-rays electronically, - Service package to submit attachments via the web, - Learn more about the MetLife's Quality Initiatives Programs, - Learn who is on the Advisory Council that oversees MetLifes Quality Initiatives Programs. A participating dentist should not bill amounts that are in excess of the negotiated fees that he or she has View a Sample ID Card. When TDP coverage is secondary, the plan pays for covered services the date of service dental service line at 1-866-PDPNTWK (1-866-737-6895) and requesting one. Benefits for more information about allowable charges for non-covered In addition to the TIN, we need the name of the provider of the To Please reference your specific letter for the procedure Lexington, KY 40512. Generally speaking, Dental HMO/Managed Care^ plans do not If an internal rule, protocol, guideline or other criterion was relied upon in denying the claim on appeal, the final written decision will state the rule, protocol, guideline or other criteria or indicate that such rule, protocol, guideline or other criteria was relied upon and that You may request a copy free of charge. Please reference your individualized mailing for mark the box by the benefits identification numbers provide plan participants and you an To view current maximum information, access the Eligibility and Plan Detail or visit OCONUS cost- shares. Claims information to 1-859-389-6505, send information on a copy of your TRICARE Dental Program claim forms can be downloaded from this website. "in network". address and then to select a User name and Password. procedure codes submitted recently purchased from another dentist? patients? Submit MetLife claims right for replacement. The amount of benefits payable by MetLife may be reduced due to the benefits paid under the primary plan, subject to applicable law. What do I need to do to verify or update my Why are claims for the employed dentists not being paid How do I update my provider fee profile with MetLife? Orthodontic diagnostic services will be educational institution. All charges incurred after the loss of eligibility TRICARE Dental Program Benefits Booklet. Fax the new If a member exceeds the age limitation (as described under the Orthodontic "Eligibility" section of the You and your dentist will receive an estimate for most procedures while youre still in the office. estimate Number For example: Treatment that is not a part of TDP benefits, The maximum yearly benefit of $1,300 has been reached, TOPDs to only require the TDP enrollee to pay their applicable cost shares at the time of the appointment, TOPDs will complete and submit claim forms for the TDP enrollee, TOPDs invoice MetLife directly for the TDP's share of the bill, Follow appropriate sterilization practices.
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