If a patient requests to submit a claim for a new PPO insurance plan starting tomorrow, what should you do?

The correct approach involves understanding insurance policy timelines and the ethical responsibility toward the patient. If a patient requests to submit a claim under a new PPO insurance plan that is set to start tomorrow, it is important to recognize that the insurance coverage is not in effect until that date arrives. Engaging in any procedures that could create a claim under a plan that is not yet active can lead to complications or denial of coverage.

Cementing the crown immediately without consideration for the insurance start date could lead to issues where the patient might not be covered for that service, resulting in unexpected out-of-pocket expenses for them. Ethical dental practice necessitates clear communication about what is covered and when coverage begins.

Instead, an appropriate course of action is to inform the patient that while the procedure can be scheduled, the claim can only be submitted after the insurance is officially in effect. Ensuring that patients understand their insurance coverage is crucial for maintaining trust and transparency in the dentist-patient relationship. This not only aligns with ethical standards but also upholds the professionalism expected in dental practice.