If the patient transfers to a different orthodontist, the new orthodontist must submit a claim to MetLife. provision may be set out in the plan itself, or governed by industry Password: Please sign in above to view. As a hypothetical example, a dentists usual fee in Jefferson City, MO for a crown might be $1,125. displays accurately on our provider directories. To verify the browser version you are using, click on New MetLife will make payment for covered services to either the dentist or beneficiary, depending on which party submitted the claim. require a copy of the prior carrier's Explanation of Benefits (EOB) Please specify if you wish to participate in the Preferred Dentist outreach that MetLife is required to conduct in order to Requirements for designation include: How do I check TRICARE Benefit Plan specifications for OCONUS Beneficiaries? Name / Practice Name What information is available for Orthodontic Payments for OCONUS Beneficiaries? Effective May 1, 2012, MetLife will become the dental carrier for the TRICARE Dental Program (TDP). X-rays Payments for certain diagnostic and preventive services are not applied against the annual maximum. Like most group benefits programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions of benefits, limitations and terms for keeping them in force. patients ID number in place of his/her SSN for all transactions. However, claims submitted electronically will typically flow party forwarded the claim, payment will be issued to the dentist. receive the benefits of participation and to be considered Learn about Group Dental insurance. under one TIN, how can we ensure payments are processing under the patient's dental plan? What is the TRICARE Dental Program? How can my patient continue their orthodontic treatment if they are moving? If you have any You may notice, however, that some ID cards Lexington, KY Even if a dentist is a member of a group practice, he or she must also apply and be accepted for participation in the Preferred Dentist Can I get an estimate of my out-of-pocket expenses? In order to obtain additional translated documents for a patient, please do the Actual payments may vary depending upon plan maximums, deductibles, frequency limits and other conditions at time of payment. In addition to the TIN, we need the name of the provider of the service to process a payment. 1st and ends April 30th. To nominate your provider, visit metlife.com/mchcp/. P.O. lifetime orthodontic benefit. please be sure to include: For MetLife to process claims, the following information is needed: How will claims be paid for OCONUS Beneficiaries? Payments can still be made to the group name or of eligibility, and are primarily used for easy reference to commonly After the initial exam is completed, the initial NARF, the claim form, and the provider's bill for the initial exam and treatment provider by the patient or sponsor. local anesthesia What are the OCONUS TDP COST SHARES? In cases in which the dentist submitted the claim, MetLife will issue payment to the dentist and a Dental Explanation of Benefits we will send a final, third letter providing another 10 days How can I apply for participation in the MetLife x-rays that you did not require in your professional judgment. NJ 08807 understand the circumstances of the services you are requesting You will need to identify the In addition to the annual maximum, there is a $1,200 accidental annual maximum (applicable to dental care provided due to an accident). These rules determine the order in which the plans will pay benefits. You may have seen recent news coverage of customers of financial services companies falling victim to social engineering scams. days. Information Currently on File How to Avoid Claims Hitting Timely Filing Period - Dental ClaimSupport Box 981987 Fee schedules are given to participating providers as part of their application and information packages. identification numbers provide plan participants and you an

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