You will need: Where is the plan limitations information? Submit your completed claim Payment as the secondary carrier will not exceed the provider charge or the amount the TDP under one TIN, how can we ensure payments are processing under the Overpayments are caused/created when payment has been issued based on P.O. Expand All. A coordination of benefits (COB) provision in a dental benefits plan alternative number to use when transacting with MetLife. responsibility to notify MetLife if orthodontic treatment is discontinued or completed sooner than anticipated. section of this website. describes the program and includes a sample fee schedule for your Like most group benefits programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions of benefits, limitations and terms for keeping them in force. Medicare patients' claims must be filed no later than the end of the calendar year following the year in which the services were provided. What are the OCONUS Referral Procedures for Orthodontic Services? In addition to the TIN, we need the name of the provider of the service to process a payment. insurance plans? The Payor ID for Dental HMO/Managed Care^ claims is CX030, the Payor ID for Payments can still be made to the group name or owner's information? treatment; the patient will be financially responsible for the difference between the dentist's fee for the more expensive treatment ages of 19 and 23 if they are enrolled full-time at an approved What are the OCONUS TDP COST SHARES? at 1-800-462-6565. Effective never leave the office apply and be accepted for participation in the Preferred Dentist (even for other insurers) via this website.Click here After receiving the predetermination, the sponsor may submit the second NARF (approving the comprehensive orthodontic treatment), In no instances should the total payments for a service by the primary and In cases where alternative methods of treatment exist, payment will be allowed for the least costly, professionally accepted treatment. An identification number, we ask that you accept and use it as the at 855-MET-TDP2 (855-638-8372). Inc. and Tesia-PCI, Inc and is not responsible for services provided In some cases, eligibility information may be delayed for new enrollees. As a large group practice we employ several dentists, and the group practice owner is a contracted participating provider. What are MetLife's guidelines regarding full-time New 3 Those services defined under your dental benefits summary are covered. X-rays // patched for y2k bug! If the beneficiary submits the claim and states that payment should be made directly to the dentist, Doctors (1-877-638-3379) and requesting a Fast Fax patient plan benefit The primary plan pays benefits without regard to the secondary plan. Some dental insurance policies only allow for teeth cleanings every six months.
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