PEP, June 2004: Check your dental statement carefully.

Public Employee Press

Check your dental statement carefully

After a dental claim is received and processed by the DC 37 Health and Security Plan, members will receive an Explanation of Dental Benefits Statement (EOB). It is very important for members to check every EOB carefully. If payment is to be made to the member, a check will be issued with the EOB. If payment is made to the dentist, the member will receive a copy of the check with the EOB. The EOB statement will outline the treatment that the dentist indicated was provided to the member or eligible dependent.

Since your dental history, including frequency limitations and restrictions, will be updated based on the information provided on the EOB, you must review this statement to determine that the dentist completed all of the procedures indicated.

If you disagree with any of the information provided on the statement, you must send a letter within 14 days of receiving the EOB, identifying the information you do not agree with. Send your letter to the DC 37 Health and Security Plan, Attention: Dental Unit, 125 Barclay Street, New York, New York 10007. If the plan does not hear from you, they will assume that the information from the dentist regarding treatment provided to you or your dependents is accurate.

Reviewing the EOB also helps to prevent fraud.