Insurance Q & A
Maximize Your Insurance Plan
Elite Dental of South Bend employs specially trained Business Assistants and Treatment Coordinators to maximize each patient’s insurance plan. Each plan is as unique as you are. We are as committed to assisting in the insurance process as we are to providing you the highest quality dentistry.
We invite all new and existing patients to use this page as a resource when calling your insurance company to verify benefits prior to your visit. If at any point in time you have a question we have not addressed, please feel free to call or email and we will do our best to answer your questions.
Dental Insurance
Note: Many insurance plans have the same benefits for in/out of network providers.
- Does the plan have assigned providers?
- Does the plan reimburse the practice or the subscriber?
- If the plan reimburses the subscriber, payment in full will be due at the time of service unless other arrangements have been made in advance.
Insurance plans typically pay a percentage of an allowed amount, not a percentage of the fee. - My plan pays ______% of the allowed amount OR _____% of the fee.
- Some dental plans require a pre-determination of benefits for certain services or for services over a certain amount.
Medical Insurance
Some medical plans require a pre-authorization of services.
Tongue and Lip-Tie/Frenectomy
Below is a table of Dental and Medical Codes used for laser revisions. Many infants are not yet on the Family Dental Plan, therefore it may be billed to the Medical Insurance. Your insurance company will be able to verify coverage with the codes provided.
| Dental Insurance (Under 3 years old) | Dental Insurance (Over 3 years old) | Medical Insurance | |
|---|---|---|---|
| Examination | Dental Insurance (Under 3 years old)D1120 | Dental Insurance (Over 3 years old)D0140 | Medical Insurance99201 |
| Tongue-Tie | Dental Insurance (Under 3 years old)D7960 | Dental Insurance (Over 3 years old)D7960 | Medical Insurance40819 |
| Lip-Tie | Dental Insurance (Under 3 years old)D7960 | Dental Insurance (Over 3 years old)D7960 | Medical Insurance99201 |