So you’ve got a dental insurance plan. That’s great. What happens when you get to the dentist, and they tell you there’s an issue with your plan? Unfortunately, in the world of systems and technology, issues can happen. Let’s take a look at how you can try to resolve your issue.
Contact the carrier’s customer service to verify they’re showing you as active
Your first step is to ensure the dental carrier shows you as active in their system. We often assume everything is alright with our info, but sometimes technical issues can arise.
Dental offices usually contact your plan administrator to verify your benefits and eligibility, but sometimes they forget to make this step. It’s a good idea to verify for yourself that everything is good on the carrier’s end.
Best case, the dental plan is showing you as active and you can ask the dental office to confirm this with the carrier on their end.
But sometimes the carrier may not show your coverage as active. This can be due to several different reasons.
Check your automatic payment info to make sure your billing is up to date
Many people use the convenience of automatic payments for monthly bills such as insurance premiums. This feature can be a great time saver and can avoid the issue of late payments.
However, most credit or debit cards will expire and be re-issued by the bank over time. When this happens, you’ll need to remember to update your new payment info with all of your companies that use automatic payments, including your dental administrator.
If your plan has lapsed because of a missed payment due to an expired card, you can often update the payment info with the carrier. Then they can draft the premium that is due. If the missed payment has been recent, they can often reactivate the plan.
However, if there has been a longer period of time since the premium was paid, the dental plan may not allow a retro activation. In this case, you may have to re-enroll in the dental plan with a current effective date. This could have a negative effect if you had previously satisfied a waiting period on the plan. This is why it’s crucial to make sure your payment info is always up to date.
Occasionally carriers will have technical system issues
Systems and technology are always changing. Sometimes these updates can cause issues between provider and carrier systems. Many dental offices will use benefit systems or web portals to verify dental benefits and submit claims.
Occasionally a technical issue due to a software update can cause a delay or mis-information in the system. If there is an ongoing system issue, the carrier will often send a notification or inform you when you call customer service. Usually they’ll resolve the problem in short order, and providers can continue to verify benefits and submit claims.
If you find out about a technical system issue on your plan, you can let the dental office know that this is the cause of your eligibility error. Then they can follow up with the carrier to re-verify your plan information once the issue is resolved.
You can contact your human resource department, benefits agent, or online web broker for assistance
Sometimes your issue may go beyond a billing or technical system issue. In this case, you may need to request further assistance from your human resources department or agent if you’re on a group dental plan. If you enrolled in a plan online, you can reach out to the web broker for assistance as well. These professionals often have direct channels with the carrier and plan administrators to escalate an issue for a priority resolution.
They may also be able to give you guidance for the best way to resolve your specific plan issue based on their experience. This is why they’re a pro.
Regardless of what issue you may be having with your plan, the good news is that most problems can be quickly resolved so that you can continue to use your dental plan’s benefits. Whether it’s an eligibility question, billing problem, or technical system issue, you can likely identify the culprit in order to get your plan back on track.
