Bonitas Member Magazine 2018 - B-Living Issue 1 | Page 27

Our dental benefits are managed by DENIS, the largest network of dental professionals in South Africa. All dental procedures have predefined benefits, which are paid at the Bonitas Dental Tariff. Remember to get pre-authorisation You need to obtain pre-authorisation for the following: • Crown and bridge procedures • Orthodontics • Implants • Hospitalisation • Intravenous / Conscious sedation • Periodontics • Plastic dentures and partial metal frame dentures You can get pre-authorisation by calling the DENIS call centre on 0860 336 346 or emailing [email protected]. What will my benefits cover? This depends on the option you’re on. The good news is that dental benefits are paid for from risk on a number of plans including BonClassic, BonFit, Standard, Standard Select, Primary and BonCap so they won’t affect your savings or day-to-day benefits. Conservative dentistry is covered on most plans. Remember, we focus on the health of your teeth, rather than their appearance. Therefore, dental problems associated with pain, discomfort, and oral hygiene are generally covered, while cosmetic dentistry such as porcelain veneers and teeth whitening is excluded. What is conservative dentistry? Conservative dentistry is also known as basic or routine dentistry. It means the diagnosis, prevention and treatment of tooth and gum diseases as well as the repair of defective teeth. This includes consultations, oral hygiene (scale and polish), fillings, x-rays, root canals and extractions. What is specialised dentistry? Specialised dentistry (also known as advanced dentistry) occurs when teeth need to be replaced or when badly damaged teeth need to be repaired, and conservative dentistry would not be adequate. Authorisation is required for some treatments before treatment starts. This includes partial metal frame dentures, implants, orthodontics, maxillofacial surgery as well as crowns and bridgework. Not all options have specialised dentistry benefits, so it is important that you check whether you are covered for specialised dentistry. B-Living Issue 1, 2018 We require the following information for pre-authorisation: • Hospital practice number • Anaesthetist practice number • Treating clinician • Hospital admission date • Procedure code(s) with ICD-10 code(s) and where relevant the applicable tooth numbers • Main reason why the procedure is needed How do I submit claims to DENIS? Submitting claims is easy! Make sure the following details are clearly visible on your claim: • Your membership number, dependant name and code • The dentist’s details and practice registration number • The treatment date • The relevant procedure – and ICD-10 codes • The tooth numbers (if applicable) Email your claim to [email protected] or post the original copies of your dental claims to Private Bag X 1, Century City, 7446, Cape Town. How do I find a dentist on the network? We cover all dentists on the DENIS network, which has several dentists located nationwide. To find a dentist on the network near you, go to www.denis.co.za and use the “Find a Dentist” tool. Select Bonitas Medical Fund from the drop-down menu, select your option, province, city/town/suburb and click the search button. You will then receive a list of dentists in your area as well as their contact details. Page 26