How do I make sure I do not go over UCR rates when filing dental claims.
Question: I have a PPO dental insurance plan that I get though work. My problem is that the last few times I got hit with what my Insurance Company calls UCR rates. The insurance company told me my dentist is above the going rates in my area for his services. I am really upset that I keep getting hit with an additional billing that I did not think I was going to have. I did make some phone call to other local dentist that do seem to be less expensive then my last dentist so I am thinking about changing dental office so that I will not have this problem. How do I go about making sure I do not go over UCR rates?
Answer: You did not state whether or not your dentist was a provider of your PPO plan. In many cases staying within the plan PPO provider list will help to keep you within the company UCR cost. (Though that is not always a 100% accurate. ) Whether you choice to change your dental office or not does not matter in confirming UCR rates with your dental insurance plan. Many insurance companies required that you submit a treatment plan before dental services are render so that they can tell you ahead of time what your coverage mount is. Doing that for all your dental services will avoid you from having any unexpected additional charges. It sounds like to me you have not been doing that. Having your dental work done before confirming your coverages will leave you at risk