Your Insurance Provider Questions to AskQuestions To Ask Your Insurance ProviderKnow Your Coverage As a courtesy to you, our staff may offer to process insurance claims on your behalf for your treatment with your consent, however each insurance plan is unique. Due to current privacy laws, many insurance companies will not provide us with any information regarding your plan. To assist you best, we encourage you to take the time to contact your insurance provider and request a breakdown. Once we have this information, we will have a better understanding of your coverage and will be happy to clarify any questions you may have. Please note the treatment options presented to you from our team are based upon our professional judgment and not based on your coverage by a dental benefit plan.Your Name* First Last Insurance Company Name*Policy or Plan #ID #Single or Family PlanSubscriber Name / Date Of BirthIs there a yearly deductible? If so, how much?Calendar or Policy year (when do your benefits renew?):*Fee Guide (current year or specific year):*Basic Coverage % and yearly maximum amount:*Major Coverage % and yearly maximum amount (Is this amount combined with your Basic maximum?):*Any Orthodontic Coverage? If so, is there an age restriction? / coverage %? / Maximum?*How many scaling units are covered per year?*Can I get coverage for more scaling units if necessary with a pre-determination?*How often am I covered for a complete exam? ( Codes 01103 / 01102 or 01101)*How often am I covered for a recall exam (Code 01202)?*How often am I covered for bitewing x-rays?*How often am I covered for a panoramic X-ray?*How often am I covered for a polish?*How often am I covered for fluoride and is there an age restriction?*Do I have any sedation coverage?*Is Oral Hygiene Instruction covered? (OHI) code:13211 - if so how often?*Are specialist fees allowed?*Is EDI allowed?*CAPTCHA
