A predetermination of benefits (or pre-treatment estimate) is a helpful tool that allows you and your patient to know estimated benefits, eligibility and financial responsibility in advance of completed treatment. We encourage predeterminations for extensive treatments like implants, TMJ, prosthetic and orthodontic procedures, veneers, crowns, gold restorations, surgical periodontics, endodontics, and oral surgery (except for simple extraction of a single tooth.) Requests for predeterminations are made by submitting a proposed treatment the same way you would a regular claim (excluding the dates of service and the dentist’s signature). You can also easily submit a predetermination online by logging in to your Dentist Account at Predeterminations are valid for 6 months.

Click here for step-by-step instructions on how to submit claims/pre-d's online.