Review Dental Claim Refresher

Q: What intent allows you to review the dental claims and provide claim status to members without the need to call the United Heathcare Dental?

• Review Prescription Claim History

• Review Medical Claim History

• Review Dental Claim History

Dental Claim - These details tell the tooth and location on the tooth in which the service was performed.

• Surface Detail -> Tooth Surface Code

• Claim Details -> Tooth Surface Code

• Service Line Detail -> Tooth Surface Code

What is the main job aid that advocate should use about dental claims?

• Vision Coverage

• Dental Coverage - Index

• Dental Benefit - Index

Dental Claims issues that cannot be resolved within Maestro. Advocate action?

• Cold Transfer to Dental Vendor.

• Warm Transfer to Dental Vendor.

• Warm Transfer to Telesales.

Dental Claims issues that cannot be resolved within Maestro. Advocate action?

• Cold Transfer to Dental Vendor.

• Warm Transfer to Dental Vendor.

• Warm Transfer to Telesales.

What information should you ask to locate the Dental Claim?

• Provider name

• Date

• Type of claim service