Dental Network of America

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Frequently Asked Questions

Topics:

Working With Us

General

  • Are Pre-authorizations required?

    They are not required; however, they are suggested for services over $300.

  • How long is a pre-authorization valid?

    They are valid through the end of the benefit period or when the policy changes, whichever comes first.

  • Will the x-rays I submitted with a claim be returned?

    No. We advise you send us a duplicate or copies of current/dated images that are of diagnostic quality. All images must be of diagnostic quality, labeled including L or R as applicable and contain appropriate landmarks views.

  • Is there a missing tooth provision?

    Use the Procedure Code Lookup field and search for procedure codes that are used to replace a missing tooth.

    If there is a missing tooth provision on the policy, the message missing tooth provision is displayed in the Other Limitations field.

Claim Processing

  • What is the payor identification number?

    Payor identification numbers are specific to the clearing house you use. Please contact your clearing house with questions regarding payor identification numbers. The most commonly used payor ID codes are as follows:

  • Do you accept assignment of benefits?

    For BCBSMT: We do not accept assignment. We make payment to the provider.

    For BCBSIL, BCBSNM, BCBSOK, BCBSTX, and Dearborn National: We accept assignment. We make the payment to the payee designated on the claim submission.

  • Do you accept signature on file?

    For BCBSMT: We do not accept signature on file. We make payment to the provider.

    For BCBSIL, BCBSNM, BCBSOK, BCBSTX, and Dearborn National: We accept signature on file. We make the payment to the payee designated on the claim submission.

  • Do you accept electronic claims and electronic attachments?

    We accept electronic claims; however, electronic attachments must be submitted through National Electronic Attachment (NEA).

Diagnostic Services

Basic Services

  • Are composite resin fillings covered on all teeth?

    Yes. Composite resin fillings are a covered benefit on all teeth; however, alternate benefit provisions may apply. Check the Claim Processing Guidelines for tooth numbers where alternate benefit provisions may apply.

Periodontics

Major Services

  • Do you pay on prep or seat date?

    We pay on seat date; however, certain employer groups may have exceptions to this rule and pay on prep date.

  • Are crowns subject to an alternate benefit?

    Use the Procedure Code Lookup field and search for a code associated with a crown. Crown, bridge, and other prosthodontic procedures may be subject to Alternate Benefit Plan provisions. Also, procedures may be subject to Professional Review.

Orthodontia