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Dental Insurance Plans

Lab Fees

Many dental services require additional commercial laboratory procedures. As your dentist can explain, dental procedures that might require the services of a commercial laboratory may include:

  • Bridges
  • Crowns
  • Dentures
  • Implant procedures
  • Inlays or onlays - small and large restorations, respectively
  • Night guards
  • Orthodontic appliances
  • Posts and cores for crown and bridge restorations
  • Repairs to any of the above restorations or appliances
  • Sleep apnea appliances
  • Sports guards
  • Veneers

Laboratory Fees are not Dental Fees
The fees charged for laboratory services are in addition to the dentist's professional fee for the service or treatment provided. In most cases, independent companies perform the laboratory services, not your dentist.

Your dentist will arrange for a commercial laboratory to do the work to precise specifications that meet your treatment needs. You will then see the fees for the commercial laboratory on your bill. It is important to understand that fees from the commercial laboratory are the exact amount that the laboratory has charged your dentist to provide the service.

When completing your claim form, the fee for the service performed by the dentist, such as a crown or bridge, will be listed as a professional fee. The laboratory charges reported on the form, using procedure code 99111, will be the fee charged by the commercial laboratory. Again, this is not the dentist's fee.

Lab Fees and Your Dental Plan Coverage
Laboratory charges must be completed in conjunction with other services. The amount payable by your dental plan will be limited to the reimbursement percentage of the services that required the lab work. This percentage is determined by the employer or plan sponsor, and plan administrators handle reimbursement in a variety of ways.

To find out the level of reimbursement that can be expected from your dental plan, you should ask your dentist prepare an estimate of the professional services and the estimated laboratory charges, which should then be submitted to your plan administrator.

The predetermination of benefits you receive back from your plan administrator will explain how your benefits for these services are calculated so that you are aware of what your costs will be, before you receive the treatment.