Questions & answers · Dental insurance
Which documents does Ameritas Life Insurance Corp.'s filed dental insurance policy require for a claim?
AI-drafted from filed documents · reviewed: pendingdocuments needed for a claimAmeritas Life Insurance Corp.
Under Ameritas Life Insurance Corp.'s filed dental insurance policy in Kentucky (KY), the policy requires that the dentist furnish Ameritas or their authorized representative with documents or reports as may be reasonably necessary to verify the accuracy of the charges, services, and supplies rendered as reflected on the dentist’s bills and claim forms [1]. This includes records of covered persons that must be available for review by Ameritas during business hours upon prior notification [1]. Ameritas may conduct onsite office visits or reviews of the dentist’s office to determine compliance with Ameritas’ standards and requirements, and all records obtained through such visits are to be treated as confidential [1].
In California (CA), the policy states that if a claim is denied on review, the insured will receive a written notice containing specific information, including the reasons for the decision and references to the policy provisions and internal rules used [2]. The insured may also request copies of non-privileged documents and records relevant to the claim, free of charge [2].
This does not appear in these excerpts — check the full policy.
Information only — not legal advice. The insurer decides.
These answers quote forms insurers filed with state regulators. Your own policy, its endorsements and your state’s rules control. A filed form may not be the version sold to you.
Where this comes from (2)
[1] Ameritas Life Insurance Corp. · KY · SERFF AMFA-135011206 · form AM 624 Rev. 6-26 · p. 3 · 2.22 · Classic Network Dentist Participation Agreement
KENTUCK Y 06-10-26 (D) Onsite Office Visits, Books and Records, Confidentiality Ameritas, or its authorized representatives shall have the right to conduct onsite office visits or reviews of Dentist’s office in order to determine compliance with Ameritas’ standards and requirements. Dentist agrees that Ameritas may conduct such visits or reviews in order to determine whether Ameritas will enter into this Agreement with Dentist and periodically thereafter. Ameritas shall treat all records that it has access to as a result of such visits or reviews as confidential so as to comply with all state and federal laws regarding confidentiality. Dentist and Ameritas agree that all Covered Persons records will be available for review by Ameritas during business hours upon prior notification by Ameritas to the Dentist. Upon request, Dentist shall furnish Ameritas or their duly authorized representative with such documents or reports as may be reasonably necessary to verify the accuracy of the charges, services and supplies rendered as reflected on Dentist’s bills and claim forms. Ameritas, the Dentist and/or their independent auditors agree to maintain the confidentiality of dental health records of Covered Persons in accordance with applicable local, state and federal laws. … (excerpt — the filed text continues)
[2] Ameritas Life Insurance Corp. · CA · SERFF AMFA-133109778 · form Ca-Notice Rev. 10-21 C · p. 1 · 3.4 · APPEAL PROCEDURE
If we deny any part of your claim on review, you will receive a written notice of denial containing: a. The reasons for our decision. b. Reference to the parts of the Policy on which our decision is based. c. Reference to any internal rule or guideline relied upon in making our decision along with your right to receive a copy of these guidelines, free of charge, upon request. D/V/H d. Information concerning your right to receive, free of charge, copies of non-privileged documents and records relevant to your claim. e. A statement that you may request an explanation of the scientific or clinical judgment we relied upon to exclude expenses that are experimental or investigational, or are not necessary or accepted according to generally accepted standards of dental practice. If you are not satisfied . . . Should you feel you are not being treated fairly, we want you to know you may contact the California Department of Insurance with your complaint and seek assistance from the governmental agency that regulates insurance. To contact the Department, write or call:
Drafted by a local AI model from the excerpts above, then checked by rules (citations, no rankings, no “not covered” claims from a partial excerpt). Question id Q9f570233. Spotted an error? Tell us.