When will the plan pay again?
Enter the plan's frequency limit and the dates of earlier services. See whether the planned visit is covered, or the first date it would be.
Runs in your browser. Nothing you type is sent to Tabruns or saved, and it asks for no patient details. Plans differ: the insurer decides what it pays.
Common limits to try
Cleanings and periodic exams: often 2 a year, or once every 6 months. Bitewing X-rays: often 1 set a year. Full-mouth or panoramic X-rays: often once every 3 to 5 years (36 to 60 months). Crowns: once per tooth every 5 to 7 years. The patient's own benefits page has the real numbers; see dental frequency limitations explained and the cleanings and X-rays billing guides.
Questions
What does “once every 6 months” mean for a cleaning?
The plan counts from the date of the last paid cleaning, at any office. Six months after that date is the first day it pays again; a visit a day earlier is denied even if it's only the second cleaning of the year. A few plans count one extra day, so if the dates are close, ask the insurer.
What's the difference between a calendar year and a benefit year?
A calendar year starts on January 1. A benefit year starts on the plan's renewal date, which can be any month. “2 per year” starts counting again on whichever of those the plan uses.
What is “2 in 12 months”?
A rolling limit: the plan looks back 12 months from the visit date. The visit is paid only if fewer than 2 of the same service fall in those 12 months.
Where do I find the dates of earlier services?
In the claims history on the insurer's portal. It shows services billed to this plan at any office, but not ones paid by an earlier plan, so ask new patients too.
Let the benefits page do the typing
Tabruns Dental reads the limits and the service history from the insurer's portal and checks every line of the estimate against them, on the office computer.
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