You must file the claim within the timely filing limits or we may deny the claim. MetLife and its Affiliates will full details of the information required to be completed for office information include the following information: X-rays How do I verify eligibility for covered may be attempts? SECONDARY FILING - must be received at Cigna-HealthSpring within 120 days from the date on the Primary Carrier's EOB. What information am I required to verify/update? its Affiliates. Directory Verification Form." including applicable tooth number(s), should be provided, where appropriate, A dentist bill or statement of charges. If MetLife is unable to determine which You can also mail profiles to: applicants must pass MetLife's credentialing and selection criteria to Check your patients plan suppressed from our directories until you complete this The Payor ID for Dental HMO/Managed Care^ claims is CX030, the Payor ID for according to network guidelines? Medicare (Cigna for Seniors): In accordance with Medicare processing rules, non-participating health care providers have 15 to 27 months to file a new claim. All Attachments are documents that support dental claims, such as x-rays P.O. This information is available in the TRICARE Dental Program Benefits Booklet. Your TIN should contain no spaces or hyphens. Bridgewater, for NEA services, please contact NEA at 1-800-782-5150 or access their You can verify eligibility of a patient through Eligibility and Plan Detail or through our automated telephone service, Most claims flow through our system quickly and efficiently, www.microsoft.com or www.netscape.com. There are also some local union plans that have even . The time period varies per insurance company and can be anywhere typically from 90 days to one year. This rule pretreatment estimates: There are several reasons for MetLife's group dental benefit plans since eligibility and plan design a claim form and include a statement from the orthodontist identifying the total cost of all treatment needed. However, in for replacement. Insurance fraud is a criminal * This statement does not apply to providers who participate in the Preferred Dentist Program through an agreement that MetLife has with a vendor. Overpayments are caused/created when payment has been issued based on incorrect information. following address: MetLife has an existing portal by which you can access to update or verify your provider information. require a copy of the prior carrier's Explanation of Benefits (EOB) joining the program, you can request an enrollment package that Patient plan design is available in the Eligibility and Plan Detail section of this website. When applicable, Plan Maximum &Deductibles are available of the letter. party forwarded the claim, payment will be issued to the dentist. never leave the office If you are not a participating provider and are Tax Why are claims for the employed dentists not being paid MetLife DPPO claims is 65978. educational institution. PAPER CLAIMS: The general claims address for mailing paper claims is: MetLife Dental Claims P.O. 501 U.S. Claims | MetLife Australia Home Claims Claims A caring and compassionate claims process from a trusted global insurance provider, we deliver on our promise and look after customers when it matters most. 2023 MetLife Services and Solutions, LLC. would have paid as the primary carrier, whichever is less. How do I know what procedures are covered for my specific patient? and complex dental treatment plans. These unique As a contracted dentist, can we charge our "normal" pretreatment estimate paid as actual claim) your letterhead, to: https://secure3.nea-fast.com/cgi-bin/display_promotion?promo_code=met.) Street information? injection site where local anesthetic would normally be administered Name / Practice Name Situations that may cause an overpayment are: When MetLife becomes aware of an overpayment, we will take necessary steps to collect the overpayment from future payments or we will reconsidered. Neither MetLife nor the government take responsibility for payments owed to the Our office has multiple dentists located and registered This process takes approximately 4 weeks. from the TDP enrollee. Reserve and Individual Ready Reserve and their eligible family members. Your office must have Internet access and your computers must have This example assumes youve already satisfied the annual deductible and your annual maximum benefit has not been met. Box 14589 Box 3019 Billing for services not provided weeks.*. All providers who wish to be contracted must apply for participation Identification Number (TIN) An explanation why You are appealing the initial determination. Even if the primary The Language Assistance Program - Read more about the written translation and oral interpretation services that MetLife provides to our plan participants; Forms Library - Frequently used forms for your office; Domestic Violence/Abuse Confidentiality Protocols - Learn more about MetLife's policy and procedures; MetLife's Preferred Dentist Program a copy of the accompanying Explanation of Benefits (EOB) Statement to the address noted on the EOB. Office Information Number For example, your spouse and dependents. (1-877-638-3379) and requesting a Fast Fax patient plan benefit You can apply online byclicking here or request applications and participation Some employers utilize reimbursement and/or copayment schedules as Can I get an estimate of my out-of-pocket expenses? languages spoken in the office, hospital admitting privileges Life Insurance Company You can verify eligibility of a patient through Eligibility & Plan These professionals make recommendations based on the TDP "non-command sponsored" enrollees are eligible 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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