Member Frequently Asked Questions

You may click on a topic to go to that section or click on individual questions.

Customer Service

1.  How can I reach ACS Benefit Services, Inc. Customer Service Department and what are the service hours?

2.  What is the Mailing Address for ACS Benefit Services, Inc for correspondence regarding my dental claims?

3.  How do I change my Name or Address?

4.  Where can I verify the eligibility effective date of my coverage?

5.  When does my coverage begin?

6.  How can I add or delete eligibility for a dependent?

ID Cards

1.  I just enrolled in the Plan.  How long will it take before I receive my ID Cards?

2.  What do I do if I need to go to my dental provider before I receive my ID Card?

3.  How can I get a replacement ID Card?

4.  What do I do if the name on my ID Card is incorrect?

Benefits, Claims and Explanation of Benefits (EOB)

1.  Where can I get a summary of my dental benefits?

2.  How do I file a dental claim?

3.  How can I verify the status of my claim?

4.  How can I tell if my Dental Plan utilizes a Dental Network?

5.  If my plan does use a Dental Network and my dental provider does not participate in the network, how can he or she apply to participate in my plan?

6.  How do I know if a dental provider participates in my plan?

7.  How are claims handled for employees with more than one Dental Plan?

8.  What should I do if my network provide is billing me for the discount amount?

9.  What should I do if I receive a bill for services which I did not receive?

10.  What can I do if I wish to appeal an adverse benefit determination?

11.  When should I ask my Dental Provider to process a Pre-Treatment Estimate?

Customer Service

1.  How can I reach the ACS Benefit Services, Inc. Customer Service Department and what are the hours? [Top]

You can contact ACS Benefit Services, Inc Customer Service Center by calling the toll-free number on your ID card. Our regular business hours are Monday through Friday from 8:30 a.m. to 5:00 p.m. (EST).

2.  What is the ACS Benefit Services Inc. mailing address? [Top]

Navigate to "Contact Us" on this web site and it will provide you with the mailing address for submitting claims and other communications.

3.  How do I change my name or address? [Top]

Generally this information is provided to us by your employer. Please contact your Human Resource Department and they will submit the changes to us.

4.  Where can I verify the eligibility effective date of my coverage? [Top]

You can contact ACS Benefit Services, Inc. Customer Service Center calling the toll-free number on your ID card. You can also verify the information by accessing the Web Member Services link on this web site.

5.  When does my coverage begin? [Top]

Refer to your SPD, Summary Plan Description, or contact ACS Benefit Services, Inc. Customer Service Center by calling the toll-free number on your ID card. You can also down load your SPD by going to V2 Benefits Web Portal. Once logged in, *** FINISH THIS ONCE MEDICALIMS IS AVAILABLE *** .

6.  How can I add or delete eligibility for a dependent? [Top]

Contact your Human Resources Department.

ID Cards

1.  I just enrolled in the Plan. How long will it take before I receive my ID card? [Top]

You should receive your ID cards within10 mailing days of ACS receiving your enrollment form.

2.  What do I do if I need to go to the doctor before I receive my ID card? [Top]

If you have just recently enrolled and need to seek dental care before your ID card arrives, ask the provider to call our Customer Service Department at 1-866-257-3259 and we will be glad to verify the eligibility according to our records. If the provider requires you pay for services in advance, submit the claim showing your payment and payment for eligible expenses can be issued to you.

3.  How can I get a replacement ID card? [Top]

Contact ACS Benefit Services, Inc. Customer Services by calling the toll-free number on your ID card.

4.  What do I do if the name on my ID card is wrong? [Top]

Please notify your Human Resource Department of the change so they can update their information and forward to us.

Claims and Explanation of Benefits (EOB)

1.  Where can I get a summary of my benefits? [Top]

Most employers distribute a SPD, Summary Plan Description, directly to their employees. Contact your Human Resource Department to request this information. You may also log on to Web Member Services on this web site and down load your Plan’s SPD.

2.  How do I file a claim? [Top]

For plans that have in-network and out-of-network benefits, generally the in-network provider will submit the claim.  Check your ID card for mailing instructions which are required for all Paper Dental Claims. You or your Dental provider can download the current Dental Form from the Forms Library on this web site. The Correct Mailing Address is on that Dental claim Form. Be sure to include the Subscriber ID number and the Employer Group Number. Both of the numbers are located on your ID card.  Out-of-network providers generally will submit the claim on your behalf. The claim should be submitted outlined above. If the out-of-network provider requires you to pay for services in advance, submit the claim showing your payment and payment for eligible expenses can be issued to you.

3.  How can I verify the status of my claim? [Top]

You may log on to Web Member Services and check the status of your claims or review claims that have already been processed. You can contact ACS Benefit Services, Inc. Customer Service Center by calling the toll-free number on your ID card.

4.  My doctor is not in my network. How can he or she apply to participate in my plan? [Top]

Ask your doctor to contact the DenteMax Network at the telephone number indicated on your ID card. Or you can go to the DenteMax Web Site and enter your provider’s information and DenteMax will contact them.

5.  How do I know if a provider is a participating provider with our network? [Top]

Contact the DenteMax Network by calling the telephone number indicated on your ID card. You may also visit the DenteMax Network website at www.dentemax.com and perform a Provider Search.

6.  How are claims handled for employees with more than one health insurance plan? [Top]

When a patient is covered under more than one dental plan, one plan will be primary and the other plan will be secondary. This is referred to as Coordination of Benefits, COB. If we are the secondary payer, we must have a copy of the primary payer's Explanation of Benefits, EOB. If the EOB is not attached, the claim will be pended for receipt of the primary carrier's EOB.

7.  What should I do if I receive a bill from the provider for services rendered? [Top]

If you receive a bill from a provider, review the bill to make sure it is not an "information only" statement. Most providers will send you a statement showing the total amount due and to inform you they billed your plan. If it is a bill, ask the provider if they've submitted the bill for payment. If they have submitted the bill, allow thirty days to receive our EOB, Explanation of Benefits. The EOB will indicate the patient responsibility which is the amount you will owe the provider. If you have not received an EOB within 30 days, the claim should be resubmitted to the address on your ID Card.

8.  What should I do if my network provider is billing me for the discount amount? [Top]

Refer to your EOB, Explanation of Benefits, to make sure you have paid the provider your patient responsibility amount (the amount will be indicated on the EOB). If the provider is billing you for the network discount amount, return the bill to the provider with a copy of our EOB indicating the discount amount applied. If the provider continues to bill you for this amount, contact the ACS Benefit Services, Inc. Customer Service Center by calling the toll-free number on your ID card. We will be glad to call the provider on your behalf.

9.  What should I do if I receive a bill for services which I did not receive? [Top]

If you feel you have received the bill in error, contact the provider and ask for clarification. If you still feel you received the bill in error, contact the ACS Benefit Services, Inc. Customer Service Center by calling the toll-free number on your ID card. We will be glad to request office notes to support their charges. And, if necessary, request a refund from the provider.

10.  What can I do if I wish to appeal an adverse benefit determination? [Top]

The right to appeal is indicated on the back of your EOB, Explanation of Benefits, and is also included in your SPD, Summary Plan Description. To start the appeals process, the Participant or a duly authorized representative acting on behalf of the Participant submits an oral or written request asking for a change in the initial determination decision regarding claim payment, plan interpretation, benefit determination or eligibility. Unless your SPD, Summary Plan Description, indicates otherwise, appeals should be mailed to the attention of the Appeals Specialist at the address noted on the top of the EOB.  The Participant, or provider/representative acting on behalf of the Participant, has 180 days after receipt of a coverage decision to file an appeal, unless otherwise required by law. If the decision is changed as a result of the appeal, you will receive an EOB, Explanation of Benefits. However, if the original decision is upheld, you will receive a written response explaining the benefit determination.  Please refer to the Claims Review / Appeal Procedures in your SPD or on the EOB for full details.

11.  When should I ask my Dental Provider to process a Pre-Treatment Estimate? [Top]

You should request your provider to submit a pre-treatment estimate for services that are going to be expensive or possibly not covered by your Plan.  A Pre-Treatment Estimate is not a guarantee of payment.  It is an Estimate of how that claim might be treated if submitted at that particular point in time.  Other claims not completely adjudicated could affect the estimate.