Insurance Question Handout Please have the following information ready when contacting your Insurance Company about your dental coverage: Name* First Last Address* Street Address City Postal Code Date of Birth* Phone Number*Type of Phone Number*HomeCellWorkEmail* Preferred Method of ContactPhoneEmailWhen Should We Contact You?*MorningAfternoonEveningName of Insurance CompanyInsurance Company Phone NumberGroup/Policy NumberCertificate/ID Number Please ask the following questions when speaking to your Insurance Company: My insurance coverage based onCalendar YearRolling YearWhat is the maximum allowable amount per person?Is there a co-payment?YesNoWhich year’s fee guide does my plan use?The following treatment has been recommended, these are the codes used by Insurance Companies to determine eligibility