Insurance and Billing
Insurance claim
An insurance claim is a request for payment sent to your dental plan, listing the services you received, the dates, and the charges.
A claim is a request for payment under a dental benefit plan. It lists the services, the dates, and the costs. HealthCare.gov calls it a request that you or your provider submits when you get items or services you think are covered.
The code on the claim, the CDT code, names the service. The plan reviews the claim and then sends you an EOB showing what it paid. Under an assignment of benefits, the payment goes straight to the dentist.
If a claim is denied, you or your dentist can ask the plan to review it. This is called an appeal. Keep your EOB and ask the office for help. A pre-determination before treatment can help avoid surprises. See the insurance and financing page.
Related terms
- Explanation of benefits (EOB)
- CDT dental code
- Assignment of benefits
- Pre-authorization (pre-determination)
- Coordination of benefits