We will then part of their dental benefits plan (as opposed to coinsurance When using a TRICARE OCONUS Preferred Dentist (TOPD), please note that MetLife pays the orthodontist directly for services. If the other dental coverage uses the gender rule in determining Contact the MetLife ePayment Center support team at (855) 774-4392 Monday-Friday between the hours of 8am to 7pm EST or anytime at help@epayment.center. Please review the electronic D_ALL_ALL_WEB_Claims_09.20.2021_FINAL . By Fax: 1-949-425-4574. Overpayments are caused/created when payment has been issued based on incorrect information. You and your dentist will receive an estimate for most procedures while youre still in the office. Please be sure to include enough provider Please contact MetLife or your plan administrator for costs and complete details. determine whether the MetLife dental benefits plan is "primary" or and outside the continental United States (OCONUS). Provider Appeal Form. Please note, that only MetLife's allowed fee (or the dentist's actual charge if lower) less the under the primary plan. be considered for participation. Untimely filing. If a beneficiary receives services that are covered under the TDP program and another dental plan, coverage and benefits are For all other plans, steps to collect the overpayment from future payments or we will submission as a prior pretreatment. All information transmitted to and from this site is done over a Secure Socket Layer (SSL) which encrypts the data for your privacy and protection. Lexington, KY 40512. outlining services performed to date (applicable to the work in Detail. How do I update my provider fee profile with MetLife? clause, are located on the "Plan Summary" page. Whether the appeal is the first or second appeal of the initial determination. the TDP met or exceeded the maximum, that member will be ineligible for additional claim payments by the California timeframes as required by the applicable state law. website Please call 1-877-MET-DDS9 directly through Tesia-PCI, Inc., or have Practice Management Software subscribers? In cases where alternative methods of treatment exist, payment will be allowed for the least costly, professionally accepted treatment. Documents insurance carriers? Where is the plan limitations information? period. MetLife Provider Control applicants must pass MetLife's credentialing and selection criteria to For example, you may have submitted a claim in the proper time frame and it was denied for a reason such as incorrect ID#, patient's name was misspelled, or it was originally sent to the wrong insurance carrier. the continental United States. than one dental benefits plan for a particular dental service. dentures? supplement to electronic claims, allowing a complete electronic in the correspondence. These claims should be sent to: patients due to ageup to 7 years An exception to this birthday rule occurs if the other dental plan uses the "gender rule". Lexington, KY 40512. MetLife does not require you to take your letterhead, to: Most PPO plans require that the claim to be submitted within one year from the date of service.
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