Your Dental Insurance

Pretreatment Review

When charges for a proposed dental service for you or a covered family member are expected to be more than $300, you and your dentist may wish to file a pretreatment review. The insurance company will determine benefits payable under the plan in advance, taking into account procedures consistent with good dental practices. Payment will be made when you file a claim as treatment is completed. Obtaining a pretreatment review before receiving a service can help reduce misunderstandings and financial surprises. You and your dentist will know how much the plan will pay, and how much your cost will be.

If your dentist's recommended procedure would not be covered, or would exceed the limits of the plan, the insurance company may suggest alternatives to treat the problem. This helps to ensure quality care at the most reasonable cost. You and your dentist can then discuss the proposed procedures and the costs involved.

   Filing a Pretreatment Review   

To file a pretreatment review, your dentist should note on a regular claim form that it is a pretreatment estimate and include the following:

• The proposed service(s)
• The fee for each service
• Any x-rays, models, or charts supporting the pretreatment review.

Claim forms are available from the Benefits Section or online. Before treatment starts, send your completed form to:

CIGNA
P.O. Box 188044
Chattanooga, TN  37422-8044