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  Guarantees

  New England Dental Administrator's
   Guarantees to You:


1. Smooth Implementation

The Guarantee:
Successful implementation to NEDA will be determined by the Plan Sponsor.
The Refund:
Plan Sponsor will be reimbursed the second month of the administration fee charged by NEDA.
2. Exceptional Customer Service

The Guarantee:
NEDA will resolve a telephone inquiry immediately or guarantee an initial update within one business day and notification upon resolution.
The Refund:
Plan Sponsor will be reimbursed $50 per occurrence
3. Quick Processing of Claims

The Guarantee:
During the course of a contract year, 90% of the Plan accurately completed claims will be processed correctly within 15 calendar days.
The Refund:
Plan Sponsor will be reimbursed the administration fee for its last month of service per the third party agreement with NEDA.
4. Accurate and Timely ID Cards and Employee Materials

The Guarantee:
If requested by the Plan, accurate identification cards and standard Summary Plan Description's will be mailed within 15 calendar days of the request.
The Refund:
lan Sponsor will be reimbursed $25 per occurrence to mail out the materials within 15 calendar days of request.
5. Marketing Service Contacts

The Guarantee:
Each Plan will receive at least 2 Marketing service contacts during a contract term.
The Refund:
Plan Sponsor will be reimbursed $50 per occurrence.
6. Timely Claims Reports

The Guarantee:
Standard claim reports will be mailed to the Plan Sponsor within 10 days following the close of the previous month.
The Refund:
Plan Sponsor will be reimbursed $50 per occurrence.
7. Patients Only Charged for Appropriate Amounts

The Guarantee:

Patients will not be charged for more than the applicable co-payment; or for any difference between a participating dentist's submitted fee and NEDA's Participating Dentist's Fee Schedule of Reimbursement. Applicable only to Massachusetts group accounts.
The Refund:
Plan Sponsor will be reimbursed $50 per occurrence.
 

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