Can I see a non par provider?
Yes. However when you choose to see a non par provider you will not receive network discounts, so you will be billed the over the BAI allowance amount as well as any deductible and co pays.
If a provider states they will accept my insurance does that mean they are a participating provider?
No. Any provider will accept your insurance but if they do not specify that they participate with your insurance you will not receive network discounts.
Is it necessary to get a pre-authorization for dental services?
Not all dental services require a pre-authorization, however anytime you are not certain if a service would be covered or not you should take the time to contact your insurance carrier and ask. For services over 300.00 such as crowns, bridges, partials and dentures the only way to know if they will be covered is to have a pre auth done.
If I use the maximum benefit allowance on my plan can I still have a check up (exam and cleaning) done?
No. Once the maximum benefit allowance has been paid then no additional services will be covered.
If I’m on vacation and I have a dental emergency can I still use my benefits with a non par out of state (or county) provider.
Yes. You can give the provider our (800) 777-2425 number to verify benefit coverage. If they prefer for you to pay them make sure you have an itemized receipt with the providers name, address and phone number. Submit a copy of the receipt with a dental claim form and your phone number and submit to BAI.
I went to the dentist and they placed a white filling in my back tooth (composite restoration) but my plan will only pay for a silver filling (amalgam) in my back tooth, now I have a bill to pay. Shouldn’t the provider have told me this before I had the filling done? Can they bill me for the non covered service?
Some providers may know the specifics of your dental plan however, since the insurance plan is your benefit it is your responsibility to know your coverage. Never assume a provider knows the specifics of your plan. Always call your insurance carrier if you are not sure if a service is covered or not. The provider can bill for the non covered charge.