Predetermination of Benefits
Predetermination of benefits is a procedure by which your dentist submits a description of your treatment plan before work starts. When you or a covered dependent requires dental care, you may ask your dentist to file for predetermination of benefits.
The Trust will review the recommended treatment and notify your dentist of the dollar amounts payable under the plan for the procedures in question. Remember that a predetermination is not a guarantee of payment. To receive benefits for the predetermined services, you or a covered dependent must be eligible when the services are rendered. Predetermined benefits are subject to all plan provisions including the calendar-year maximum of $1,750 per person.
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