Below are answers to some common questions Members have about their Plan. If your
question isn't answered below, please email us at askusaquestion@cpsdentalinc.com
A. You can call CPS at (212) 889-5858 and if you reside out of New York please
call our toll free number (800) 456-6140.
After you receive your dental treatment, your dentist will submit a bill
for payment for services rendered. After CPS processes the bill and the dentist
is paid, you get an explanation of benefits statement describing the services provided
to you by the dentist and the payments made to the dentist for these services. If
you believe that there is any discrepancy between the statements you received and
the services actually provided please let CPS know about it so we can follow up
with the dentist.
CPS has a computer based voice response system that is up and running
all the time, 24/7. If you use a CPS participating dentist, your dentist can obtain
eligibility information any time of day and any day of the week. Off network dentists
will have to call CPS during regular work hours to verify your eligibility.
A. You can change your dentist any time you wish. However CPS recommends
that if you are undergoing a regimen of treatment you complete that course of treatment
with the dentist before switching to a new dentist.
A. Please have your dentist contact our provider relations department during
regular business hours at (212) 889-5858.
A: HIPAA Privacy Rules and Compliance with Federal and State Employment Laws require the following:
That neither the health plan nor a health care provider ("covered entities") may release protected health information (PHI) to a third party unless the participant gives his or her written authorization. Even when the covered entity is authorized by the member to release PHI to a third party, the covered entity may only release the minimum PHI necessary to meet the purpose of the authorization.