DENTAL BENEFITS FOR QP EMPLOYEE 

A-Covered Benefits 

1-  X rays as part of a covered treatment 

2-  Extraction 

3-  Filling with amalgam , composite or GIC 

4-  Root canal treatment 5-  Gum treatment (Periodontal therapy),except scaling and polishing. 

6-  Inlays, on lays and crowns in case filling with amalgam or composite cannot adequately restore the tooth. 

7-  Oral surgery (related to dental) and follow up treatment 

8-   Orthodontic care IOTN 4-5, subject to referral from QP dentist only and secondary approval by medical committee based on photographic evidence 

9-  Out-of-hours emergency dental care 

10- Bridges & implants , if it is medically needed to restore the function 

B- Exclusions: 

1-  Any treatment that is not covered under covered benefits 

2-  Any dental services that are performed by a Non qualified dental practitioner 

3-  Any treatment that is deemed not clinically necessary as per the medical committee 

4-  Excess of covered limit 

5-  Cosmetic dental treatment including bleaching and veneers 

6-  Orthodontic treatment (IOTN - 1, 2 and 3) 

7-  Polishing and whitening of teeth 

8-  Removal of an amalgam restoration and its replacement unless there is an evidence of recurrent decay or breakdown 

9-  Dental treatment as a result of self inflicted injury. 

10- Out of hour’s dental consultations other than for emergency care 

11- Dentures    

C- Covered Preventive Dental Health Benefits at QP Clinics Only Once a Year For Free 

1- Routine dental examinations and X-rays 

2- Fluoride treatments 

3- Protective devices of teeth (sport guards, night guards) 

4- Space maintainers, and space retainers 

5- Cleaning, scaling and oral hygiene instructions 

D- Claims Procedure

1-  This benefit is for all the QP employees and their dependents as per QP HR policy. The dental limit, per policy year, per person being QR. 4500.

2- If the treatment is done in QP clinics, the amount of the treatment done will be deducted directly from the patient limit

3-  If the treatment is being done outside QP clinics, or outside Qatar, it will be under reimbursement basis.

4-  The member should submit a fully completed claim form, signed and stamped by the dentist to Al Koot within 90 days of the treatment, for reimbursement (special consideration can only be given if reasons for delay are clearly justified and subjected to prior approval by the medical committee).

5- Original medical report (if any), bills must be attached to the claim form.

6- All the claims will be reviewed and evaluated by a professional dentist in Al Koot to decide about the eligibility of coverage and benefits.  

7-   Al Koot shall register the claim upon receiving the complete documents, and payments will be released, the following  month from the date of registering the claim.

8- On monthly basis the reports will be send to QP & the amount will be credited in the members payroll. 

9- Al Koot will not be responsible for payment to the MEMBER for any amounts that exceed his/her dental limits.