Before submitting a claim, providers can view a pre-claim estimate in the Direct Dental Provider Web Portal, which allows them to see how the claim will be adjudicated by Direct Dental. This report gives providers a preview of the member’s covered benefit amount and the amount that the member will owe for services provided. Please be advised these results are only estimates and they are not a guarantee of payment.
The pre-claim estimate also displays any exceptions or errors that may prevent the claim from being processed and paid, allowing providers to make changes before submitting the claim for processing.
How to Request a Pre-Claim Estimate in the Provider Portal
Navigate to the Direct Dental Provider Web Portal
Select Submit Claims from the Claims tab in the top navigation panel.
Fill out the claim and select the View Estimate button at the bottom of the page.
You’ll see Direct Dental's estimated payment and the patient’s portion often within moments.