Pre-treatment estimate

What is a pre-treatment estimate?

A pre-treatment estimate is a written estimate of the benefits that may be available to you under your dental plan. This estimate is requested by your dentist for a proposed treatment and is provided to you by your dental plan before you receive the treatment.

When should I request a pre-treatment estimate from my dentist?

You can request a pre-treatment estimate at any time; however, specific instances when you may want to request one include:

How long does it normally take to receive a pre-treatment estimate?

If all information is received with the initial request for pre-treatment estimate, please allow 10–14 business days for processing. To receive a pre-treatment estimate even faster, have your dentist submit the request online.

Note: A pre-treatment estimate is provided for informational purposes only and is not required before you receive any dental care. It is not a prerequisite or condition for approval of future dental benefits payment. You will receive the same benefits under your plan whether or not a pre-treatment estimate is requested. The benefits estimate provided on a pre-treatment estimate notice is based on benefits available on the date the notice is issued. It is not a guarantee of future benefits or payment.

Availability of benefits at the time your treatment is completed depends on several factors such as, but not limited to, your continued eligibility for benefits, your available annual or lifetime maximum payments, any coordination of benefits, the status of your plan and the dentist, your plan's limitations and any other plan provisions. A request for a pre-treatment estimate is not a claim for benefits or a preauthorization, precertification or other reservation of future benefits.

 

Last updated 2/20/2015