Questions & answers · Dental insurance
Which documents does Standard Insurance Company's filed dental insurance policy require for a claim?
AI-drafted from filed documents · reviewed: pendingdocuments needed for a claimStandard Insurance Company
Under Standard Insurance Company’s filed dental insurance policy in Kentucky (KY), the insurer may request documents or reports from the dentist that are reasonably necessary to verify the accuracy of charges, services, and supplies rendered as reflected on the dentist’s bills and claim forms [1]. The dentist agrees to provide such documents upon request [1]. The policy also states that all records of covered persons will be available for review by the insurer during business hours upon prior notification [1]. However, this does not appear in these excerpts — check the full policy for additional documentation requirements beyond what is specified in the excerpts.
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] Standard Insurance Company · KY · SERFF AMFA-135011584 · 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] Standard Insurance Company · CA · SERFF AMFA-133109823 · form Ca-Notice Rev. 10-21 C · p. 2 · 3.4 · APPEAL PROCEDURE
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 Qb067a27a. Spotted an error? Tell us.