Below is the 7-step process to get your medical insurance to pay for dental implants:
Step 1: Click on the link for the Insurance Assessment Form.
Step 2: An email will go from our platform to upload front and back of your ID and Insurance card in a HIPAA protected environment. Know your privacy rights under HIPAA by clicking here - https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html
Step 3: We verify implant/implant based prosthesis coverage with your medical insurance. We will send a denial email to you if there is no implant coverage. Please note that implant coverage is typically available with PPO plans only. HMO, EPO and Medicare based plans do not typically provide for any implant coverage.
Step 4: Once implant coverage is established, we send a detailed questionnaire to capture medical history, medications, and an assessment of the current situation and how it is affecting your daily life.
Step 5: Next we schedule a medical consultation with one of our participating providers. At the consult advanced radiographs (CBCT) are taken to assess the condition of the teeth and bone loss (atrophy). There is no charge to the patient for this diagnostic assessment. A detailed medical necessity documentation is created and submitted to your medical insurance company. If we are not able to establish medical necessity, we will inform you. In that case we will offer alternative treatment and payment plans which may be combined with your dental insurance to come up with an affordable implant-based solution.
Step 6: For those patients for whom we can establish medical necessity, we request the insurance company to pre-authorize the treatment. We will then set up options for payment plans for deductibles/out of pocket should you need one.
Step 7: Treatment is rendered, and you have a beautiful smile.