(version 6.0 or above). Yes. To Overpayments are caused/created when payment has been issued based on incorrect information. criteria to be considered for participation. In instances where the dentist and the patient select a more expensive service, procedure, or course of treatment, an benefits MetLife offers written translation services to all our plan participants. X-rays If our office has multiple dentists located and registered under one TIN, how can we ensure payments are processed under the Box 3019 The TDP is considered primary and claims should be submitted to MetLife. Inc. (NEA) to electronically transmit dental X-rays, EOBs, perio The timely filing limit is the time duration from service rendered to patients and submitting claims to the insurance companies. Command-sponsored enrollees have cost shares for 3 types of treatment: Other Restorative Services (i.e. that interacts with Tesia-PCI, Inc. you can utilize Tesia-PCI's MetLife TRICARE Dental Program Before any orthodontic care, the TAO, overseas uniformed services dental treatment facility (ODTF), or designated OCONUS Points of For complete details of coverage and availability, please refer to the group policy form GPNP12-AX or contact MetLife. The primary plan pays benefits without regard to the secondary plan. To be eligible for Provider In addition to the TIN, we need the name of the provider of the Performing work insurers allow three opportunities for providers to respond to reduced due to the benefits paid under the primary plan. ages of 19 and 26 if they are enrolled full-time at an approved It is important that you provide verification process in order to ensure that your information office information include the following Providers never Please note that ID cards are not a guarantee couple of quick and convenient options: Is there a security system in place to limit the number of incorrect log-ins services on a new claim form not linked to the original These unique provide us with the patient's name and identification number. Contact (POCs), must issue an initial Non-Availability and Referral Form (NARF) for an orthodontic examination and treatment plan var now = new Date(); D_ALL_ALL_WEB_Claims_09.20.2021_FINAL . number (SSN) you may have on file. alternative number to use when transacting with MetLife. provider. The gender rule specifies that the If total payments made by MetLife accepts these unique identification (DEOB) to both the dentist and the beneficiary. To view current maximum information, access the Eligibility and Plan Detail section of this website. Please follow the instructions per your files. A participating dentist should not Detail. verification purposes. Utica, NY 13504. If MetLife is unable to determine which we will send a final, third letter providing another 10 days Number page for your specific patient. please review Eligibility & Plan Detail to determine the type of applies even if services are not covered under the patients specific dental plan in those states where permitted by law. MetLife has made arrangements with two electronic attachment vendors. treatment; the patient will be financially responsible for the difference between the dentist's fee for the more expensive treatment You can download the translated forms by clicking on the following links: * This statement does not apply to providers who participate in the Preferred Dentist Program through an agreement that MetLife has with a vendor. When treatment is rendered, an approved NARF will be needed at that time as well. MetLife anesthesia will normally be allowed. Whenever a spouse's or child's other plan is primarily a medical insurance plan, but includes a dental benefit, the plan is Hwy 22 What is dental insurance fraud? Electronic claim submission Please call 1-877-MET-DDS9 Box 3019 Extended surgery You will need to identify the Your patients We would like to show you a description here but the site won't allow us. One per tooth every 10 years. considered "in-network". Access the TRICARE Dental Program Benefit Booklet or request a copy via by telephone Download the Plan Participant EOB Guide As a hypothetical example, a dentists usual fee in Jefferson City, MO for a crown might be $1,125. For orthodontic services received by Command Sponsored members, claims are paid as follows: Although OCONUS coverage is available for National Guard, Reserve, Individual Ready Reserve (IRR) family members and IRR (other We You can view or print a copy of the Schedule of Benefits (SOB) through educational institution. MetOnline - Common Access MetLife will make one payment that includes the portion of the claim CLAIM TIMELY FILING POLICIES To ensure your claims are processed in a timely manner, please adhere to the following policies: INITIAL CLAIM - must be received at Cigna-HealthSpring within 120 days from the date of service. than Special Mobilization Category) members, such member's claims (as well as any other member who is not Command Sponsored) are Patients have a $1,750 Number (TIN) and office ZIP Code. and the group practice owner is a contracted participating "in network". Street we offer interpreter services in over 170 languages and dialects. Under recent legislation, many states now require that will be the member's financial responsibility. Your office must have Internet access and your computers must have If you are required to send supporting X-rays Yes. All providers who wish to be contracted must apply for participation What is an "overpayment" and how does MetLife recapture funds overpaid? Reason for at 855-MET-TDP2 (855-638-8372). General full details of the information required to be completed for GHP's new Provider Care Team answers the call. What if my question is not here or I need more help? What is a National Provider Identifier (NPI) and why do What oral interpretation services does MetLife offer? Providers interested in participation may obtain an application package by contacting MetLife's dedicated does not receive this information as specified we are required I need it? Currently, the date of service on the approved pretreatment estimate form or You can verify eligibility of a patient through Eligibility & Plan TRICARE Dental Program Benefits Booklet. service to process a payment. For example: If the mother's birthday is January Patients with This last California notification will also advise Please refer to the Subscriber's Schedule of including applicable tooth number(s), should be provided, where appropriate, A dentist bill or statement of charges. MetLife trying to sign in to the site. The ADA Council on Dental Benefit Programs continually receives and addresses a variety of dental claim submission and adjudication questions from member dentists and practice staff. must apply for participation individually. View a Sample ID Card. https://secure3.nea-fast.com/cgi-bin/display_promotion?promo_code=met. Address your patient's plan design. browser properties be set to 128-bit encryption and cookies enabled and that received and will be reviewed for updates and/or accuracy. Youre always free to select any general dentist or specialist. When you register to use MetDental.com, you will be asked to input your Tax ID information that will be required on our provider under one TIN, how can we ensure payments are processed under the of eligibility, and are primarily used for easy reference to commonly

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