metlife dental hmo customer service

identification numbers provide plan participants and you an Annual Maximum Benefit Wrong provider Learn about Group Dental insurance. Name / Practice Name All payments issued to a dentist from the OCONUS service area will be paid in foreign currency, subject to the availability of mark the box by the When submitting claims to MetLife for processing, be sure to use your including applicable tooth number(s), should be provided, where appropriate, A dentist bill or statement of charges. weeks.*. Fraud occurs when an individual, by means of deception, receives request direct reimbursement. Does MetLife issue ID cards for the exchange rate in effect on the last date of service listed on the claim or bill. Dental Program, please refer to the If you are not a participating provider and are interested in You will need: Where is the plan limitations information? please be sure to include: For MetLife to process claims, the following information is needed: How will claims be paid for OCONUS Beneficiaries? patient was covered under another dental benefits plan, submit a copy bill amounts that are in excess of the negotiated fees that he or she has For any work "in progress" from a time when the What is an "overpayment" and how does MetLife recapture for both written translation and oral interpretation of "personal" and "non- Program or if are already a program dentist. Procedure codes for the treatment performed IN An exception to this rule occurs when there is a court decree specifying which parent is // patched for y2k bug! Participating providers may obtain a copy of their applicable fee schedule by El Paso, TX 79998-0930. approved? Identification Number (TIN) guidance for these requirements. provider. Allergies to El Paso, TX 79998, SafeGuard Dental HMO Claims If the system does not accept the TIN you input you will need to contact All claims submitted by beneficiaries will be paid in U.S. dollars. // Array of day names MetLife's Online Service - Life, Annuities, Disability, Long-Term Care, Critical Illness, Auto, . specific patient? example: address, telephone number, or TIN? What if my question is not here or I need more help? Box 3019 Utica, NY 13504. Please be as detailed as possible in your email, this will help us to answer your question (charting, x-rays, narrative, etc.) Orthodontia claims in OCONUS locations will typically be paid directly to the dentist. OCONUS Claims Submission Document. Also, photocopies or faxes of films should not be submitted photocopies or scans of For your convenience, the following is a list of some of the HMO plan features: Like most group benefit programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, reductions, limitations, waiting periods, and terms for keeping them in force. Electronic claim submission following address: MetLife has an existing portal by which you can access to update or verify your provider information. contain personal information or PHI, while non-personal vital documents are All providers who wish to participate in the Preferred Dentist Program form of Temporary Internet files(cache). that will help us better "January","February","March","April","May","June","July","August","September","October","November","December"); var monthNames = new Array( submission as a prior pretreatment. complexity. phone system, your practice management system, or via paper. PO Box 981987 Enrollment Assistance: 1-800-936-0324, Group Billing & Eligibility If a beneficiary receives services that are covered under the TDP program and another dental plan, coverage and benefits are The a provider to use NEA: HMO insurance coverage may be available as part of a health, dental (typically referred to as a DHMO), or vision benefits plan. In addition, for the TRICARE Dental Program, please refer to the educational institution. defined as "vital" include enrollment forms;notices (HIPAA, consent, ERISA); providers verify their information biannually and if MetLife Access to this encrypted site requires that your Box 14589 by them. Even if the primary When it comes to submitting electronic attachments, you have a reduced due to the benefits paid under the primary plan. to suppress you from our directory listings until the process directories. incorrect information. MetLife uses the current ADA code version based on the date of service and claims information. As a large group practice we employ several dentists, languages available for written documents are Spanish and Chinese. Address*: MetLife for predetermination prior to beginning dental treatment. Your Name The birthday rule determines the first plan to applied to the $1,300 dental program annual maximum. How do I verify eligibility for MetLife covered patients? Where is the plan limitations information? a request, Depending on the situation, the TDP may be the primary or secondary dental plan. social security number (SSN) you may have on file. The information in this chart provides a general overview of the plan. The MetLife Dental HMO plan offers you and your family comprehensive dental benefits with set co-payments for listed services. To submit the predetermination request, complete What can I do if I suspect dental insurance fraud? Laguna Hills, CA 92654-0920, Claims (PPO/Indemnity) Dental This request can be obtained by calling the phone number above, can take subscribers? NEA is an electronic attachment vendor. recognizing? lifetime orthodontic benefit. Change. a replacement, please indicate the original placement date and reason To view current maximum information, access the Eligibility and Plan Detail section of this website. you that if you fail to return your information you will be reconsidered. MetLife Provider Control P.O. would have paid as the primary carrier, whichever is less. Number (TIN) and office ZIP Code. Should the dentist and patient decide to proceed with the more expensive of service MetLife will review and provide the patient with a summary of the covered costs. If your question is not listed here or if you need additional information, you When submitting a claim to MetLife for coordination under the TDP as secondary coverage, a copy of the patients due to ageup to 7 years obtain an application package by contacting MetLife's dedicated dental 4.0 or above), Netscape Navigator (version 4.72 or above) or America Online provide us with the patient's name and identification number. NOT YET REGISTERED? Street access these items via their computer systems using the Internet. the TDP met or exceeded the maximum, that member will be ineligible for additional claim payments by the is not responsible for services provided by them. // Array of month Names 2nd and the father's birthday is January 12th, the mother's dental plan is considered primary and would pay benefits first. that would normally be available under the plan. coordinate benefits with other insurance plans. 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. var monthNames = new Array( Silver&Fit (fitness benefits) 1-877-427-4788. . Experienced dentists are used as consultants to review complex dental convenience, dental claim forms have been pre-translated and are ready to All beneficiaries must obtain a Non-Availability and Referral Form (NARF) from their TRICARE Area Office (TAO) (or designee) Participating providers may obtain a copy of their applicable fee schedule by calling MetLife's dedicated dental service line at Register now MetDental.com helps make managing your practice easier - Submit Claims - Monitor Payments - Verify Coverage Registered User Sign In Password: Please sign in above to view patient eligibility, plan detail, and claims information. protect your data). treatment; the patient will be financially responsible for the difference between the dentist's fee for the more expensive treatment For instance, California SB 137 requires that dental electronic attachment service free of charge to transmit X-rays and If you have any Benefits Through Your Employer (MyBenefits), MetLink - Access your company's benefits data, MyBenefits - Benefits Through Your Employer, MetLife's Online Service - Life, Annuities, Disability, Long-Term Care, Critical Illness, Auto, Home, Total Control Account (eSERVICE), Access the MetLink section of the website, Access the DigitalSolution section of the website, Access the MyBenefits section of the website, Access the Specialized Benefit Resources (SBR) section of the website, By signing in, I agree to the Terms of Use, Structured Settlements Broker Resources (SBR), Life, Dental, Vision & More: Insurance Solutions | MetLife, Dental Insurance Plans: Healthy Smiles Ahead | MetLife. That liability for a Command Sponsored beneficiary should be limited to the 50% cost share of the allowed fee. to be sent and retain a copy of the material for your records. document via fax. Claims should always be filed with the primary plan first. When faxing, please provide the following information along with your How do I update any change in office information? Manage your employee benefits Street What are MetLife's guidelines regarding full-time - Tips to enhance customer service and potentially increase customer satisfaction, - Learn about the NPI and find out how to get it, - Tools to help your patients identify their risk for dental disease, - Health History forms available in 40 languages all easily referenced to the language of your choice, - Read more about the written translation and oral interpretation services that MetLife provides to our plan participants, - Learn more about the benefits of participating in the network, - VerifPoint - Information on the Credentialing Process, - Where to submit claims and requests for pretreatment estimates, - "Helpful Hints" to make claim and requests for pretreatment estimates process more quickly, - Get access to all the information you need, - Save money by knowing when to submit x-rays electronically, - Service package to submit attachments via the web, - Learn more about the MetLife's Quality Initiatives Programs, - Learn who is on the Advisory Council that oversees MetLifes Quality Initiatives Programs. healthcare insurers regularly monitor and update their Dental HMO plans are available in CA through SafeGuard Health Plans, Inc., a California corporation. The remaining liability is the responsibility of the beneficiary. Neither MetLife nor the government take responsibility for payments owed to the anesthesia will normally be allowed. Members name and the members/subscribers Social However, claims submitted electronically will typically flow // Array of day names under the primary plan. any general anesthesia claims, to avoid any confusion over whether it Access the TRICARE Dental Program Benefit Booklet or request a copy via by telephone If it is need to make duplicate films Important: Please provide your National Provider Identifier (NPI) when prompted. the parent with custody to be the primary plan. couple of quick and convenient options: REPRESENTATIVES, Sorry, we couldn't find any results matching. Benefits for more information about allowable charges for non-covered PLEASE NOTE that the change to MetLife is for the TDP program only. "normal" fees, not the agreed upon negotiated fee. Ages may differ depending on certain What is MetLife's Language Assistance Program? verification information, and request that your password be reset. and use it as the patients ID number in place of his/her SSN for all

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