Introduction If your current dentist is no longer in the MetLife network, you might be wondering how to handle your dental claims and reimbursement. This article provides information about out-of-network coverage, tips for the reimbursement process, and whether you should consider finding another dentist.

Steps/Procedures

1. Understanding Out-of-Network Coverage

   • Higher Costs: Typically, out-of-network services can be more expensive than in-network services. Check your specific dental plan details to understand the cost differences.
   • Submitting Claims: Both in-network and out-of-network providers can submit claims electronically or via paper.

2. Claim Submission Options

   • Provider Submission: If your dentist agrees to submit the claim, they can do so electronically or by mailing a paper claim to MetLife. The reimbursement for plan benefits will go directly to your dentist.
   • Self-Submission: If your dentist refuses to submit a claim, they will need to complete their portion of a claim form. You can then submit this claim to MetLife. You can choose to have the reimbursement sent to either your provider or yourself. If sent to yourself, you will be responsible for paying your dentist.

3. Reimbursement Process

   • Paper Claims: If you need to submit a paper claim yourself, ensure that your dentist completes their part of the claim form. Then, send the completed form to MetLife.
   • Direct Reimbursement: When submitting the claim, you can request that the reimbursement be sent directly to you or to your dentist. If it’s sent to you, make sure to settle the bill with your provider promptly.

4. Finding an In-Network Dentist

   • Cost Savings: Using an in-network dentist usually results in lower out-of-pocket costs. Check the MetLife provider list to find in-network options near you.
   • Convenience: In-network dentists typically handle all claim submissions, making the process smoother for you.

Troubleshooting

• Claim Submission Issues

  • Ensure all parts of the claim form are completed correctly.
  • Verify that your dentist has filled out their portion of the form if you are submitting the claim yourself.
  • For electronic claims, confirm with your dentist that the submission was successful.

• Reimbursement Delays

  • Check with MetLife for the status of your claim if you experience delays.
  • Ensure that all required documentation has been submitted.

Related Resources/Links

• Finding an In-Network Dentist
• How to Submit a Dental Claim to MetLife
• Contact MetLife Support