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Dental Claims Processing – United Concordia Dental Insurance

Claims

Understanding your dental claims

 

To get started, view your plan details and claim information online

Knowing what is covered by your policy is the first step toward understanding what happens with your claim. How much does United Concordia pay? How much do I pay? You can view this information and more in My Dental Benefits:

  • What services are covered under your plan
  • How much United Concordia will pay for each service
  • The status of your claim
  • Explanations of Benefits (EOBs) for claims
  • Procedures you’ve received in the past
  • Find a dentist in your network

Sign in to My Dental Benefits Create an Account

 

How much can a dentist charge you?

We’ve worked with our network dentists to negotiate discounted fees (or maximum allowable charges) for services. Our network dentists have agreed to accept these as payments in full for covered services.

That’s the big difference between network and non-network dentists. Network dentists can’t bill you for the difference between their standard charges and our negotiated fees, and non-network dentists can. Both will charge you for applicable deductibles and coinsurances, which vary based on your dental plan.

 

Do you have to file a claim for each dental visit?

It depends. Network dentists will file claims on your behalf. A non-network dentist may ask you to complete and submit your own claims.

Download claim forms here

 

Is it easy to check claim status?

Couldn’t be simpler. Just sign in to My Dental Benefits. Choose the member’s name and then select Claim Information. You can check claims by specific date or date-range.

 

What is an Explanation of Benefits (EOB)?

An Explanation of Benefits (EOBs) is a statement that shows the service you received and from which dentist, how much United Concordia paid for that service, and how much you are responsible to pay. See more details on reading an EOB

 

Where do I go with claims questions?

Just contact us and one of our representatives will be happy tohelp.

 

Why you can’t get your child’s or spouse’s claim information

Due to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), United Concordia is only permitted to share information regarding your own claims and any dependents under the age of 18. This includes spouses. 

We take our members’ privacy seriously. With your dependent or spouse’s written permission, we can release information to specified individuals over the phone. Without this permission, dependents age 18 and older will need to call us toll-free at 1-800-332-0366, Monday through Friday from 8 a.m. to 8 p.m. ET., to get their own information from customer service. 

Visit the Patient Privacy Information Center to download a HIPAA Privacy Authorization Form. Ask your dependent or spouse to submit this form to us for the release of information.

 

Other resources

Learn how your dental plan works

How to read an Explanation of Benefits (EOB)

Get state-specific rules about your plan

Contact customer service