What is a Claim?

A claim is a request for payment that you or your dentists submit to your dental insurance company after you receive services. 

If you receive treatment from an in-network dentist, they will submit the claim for you. However, if you receive treatment from an out-of-network dental provider, you may be responsible for submitting claim information to your dental insurance company.

Examples:

• After your dental visit, your dentist submits (files) a claim to your insurance company for the services provided. The insurance company verifies your dental benefits and processes the claim for payment.
• The dentist is responsible for the accuracy of the dental services provided.
• You are responsible for the accuracy of your personal and insurance information, such as your Social Security Number, date of birth, name of your dental insurance company, etc., so make sure those details are up to date.

FAQs

• What shall I do if my claim is denied? Contact your dental insurance customer service department and find out why.

Insider tip: Inaccurate claim information, such as input errors or missing Social Security Numbers, is one of the main reasons why a dental claim might be denied. Find out more and what you can do. 

• How long does it take to process a claim? Processing times vary. It can take anywhere from a couple of days to a few weeks.

Video

This short video explains the 4 most common reasons why a claim might be denied—and what to do.

Delta Dental of Arkansas Offers Dental and Vision Insurance for Individuals and Groups

Are you interested in our dental coverage plans so you don’t have to pay the full dentist bill yourself? Check out our insurance options for individuals and families, and small, mid-size and large groups.

And while you’re browsing, take a look at our vision insurance, too.

 

More Dental Insurance Terms Explained

1. What is a premium?
2. What is a waiting period?
3. What is a network dentist?
4. What is a benefit period?
5. What are preventive/diagnostic, basic and major dental procedures?
6. What is a deductible?
7. What is a copay?
8. What is co-insurance?
9. What is an annual maximum?
10. What is a claim?
11. What is an explanation of benefits (EOB)?
12. What is a pre-determination of benefits?
13. What are out-of-pocket expenses?

Back to Dental Insurance Terms Explained: A Quick Guide

 

Are there additional dental insurance terms you’d like us to add to this series?

Email your requests to marketing@deltadentalar.com.