Dental Insurance in Dayton Ohio

When an organization which consists mainly of Attorneys (The US Congress) undertakes to reform the Medical and Dental Healthcare System, prudent persons need to understand:

1. What coverage they have.
2. What coverage they will lose.
3. What coverage they will be able to add, and
4. What it will cost.

Many folks don't want to be bothered by details and many folks are unpleasantly surprised to discover that they are not insured for the dental care they require.

Insurance companies love to collect premiums-it's how they make money.  But they also can make money by creating policies that limit the benefits they pay out.

Your employer (in most cases) and the insurance company negotiated to arrive at the benefits you will receive.  If you understand your dental insurance coverage, you will be in a better position to maximize your benefits.

I have listed, below, the schedule of benefits that might be in the majority of dental insurance plans.  Use this to ask your insurance benefit info coordinator to fill in the blanks.

Once you have filled in the blanks, you'll be able to help your employer design the coverage you need, and understand the adequacy and value of your coverage.

You can download this file:
http://soundentistry.com/understanding-ohio-dental-insu/?SSScrollPosition=0

*all fields must be filled out to apply benefits to your treatment plan

Patient Name: ___________________ Subscriber Name: ___________________

Patient Date of Birth: _____________ Subscriber Date of Birth: _____________

Subscriber SS# or ID#: _______________

Subscriber’s Employer: ______________

Insurance Carrier: _______________ Group #: ____________

Claims Address: _______________________________________________________Payor ID #: _________________________

Phone Number: __________________

Coverage Rates: (if a “fee schedule” is in place, please attach)

1. Diagnostic and Preventative _______ %
2. Endodontic _______ %
3. Periodontic _______ %
4. Oral Surgery _______ %
5. Fillings _______ %
6. Crowns and Bridges _______ %
7. Sealants (up to ____ years old) _______ %
8. Deductible: $_______ Waived on Diagnostic/Preventative? Yeso Noo
9. Annual Maximum: $_______ Calendar Year? Yeso Noo
10. (if no, what month starts the benefit year? ____ )
11. Benefits used to date this benefit year: $_________ Deductible met? Yeso Noo
12. Do you reduce coverage to the amalgam rate for posterior composite fillings? Yeso Noo
13. Do you pay crowns and bridges at the prep or seat date? _______
14. Are there any waiting periods? (if so, please list) ___________________________________
15. Is there a missing tooth clause? ___Yes oNo oCongenitally missing teeth only
16.  
17. (D0210) Full Mouth Series of X-rays are covered every ______ years/months
18. Date of service of the last full mouth series done for patient(s): __________
19. (D0274) Bitewing X-rays covered every _______ months OR ____ times per year
20. (D1110) Regular cleaning (called a “prophy”) covered every _____ months OR ______ times per year
21. Fluoride covered every ______ months OR ____ times per year through age _______
22. (D4910) Periodontal Maintenance covered every _____ months or ____ times per year
23. (D4355) Full Mouth Debridement covered? Yeso Noo How often? ___________________________
24. (D4341) Root Planing and Scaling: each quadrant covered every ______ months/years

Insurance Rep Name/Date: ___________________
Patient Signature: _________________________