It’s the process of submitting a claim through multiple edits to ensure appropriate payment. When a claim is processed this way without any human interaction, it’s called auto-adjudication.
It includes general administrative services such as billing, claims processing, and other expenses.
Allowable charge is the fees on which plan deductibles, coinsurance, and maximums percentage are based, and dentists are reimbursed for the services rendered as per their agreement with insurer.
It’s the total cost that needs to be paid by you (patient) and member company.
It’s a branch of the dental prosthesis that deals with the replacement / restoration of teeth by artificial substitutes that cannot be removed from the mouth.
It’s a treatment for restoration of the edentulous maxilla with implants.
It’s defined as a fixed removable prosthesis, specially designed to improve esthetics, stabilization or function for a limited period of time.
A type of dental device designed to replace multiple missing or damaged teeth. It’s also called dentures.
The people who are covered in your dental insurance plan are called Dependents. It can include your spouse, parents, children, etc. It’s generally defined by terms of your dental plan.
Your dental insurance plan pays for these services without deductibles or co-payments. These services usually include cleanings, x-rays, exams, fluoride treatment, sealants and space maintainers. Diganostic and Preventive Services are also known as Class I, Group I or Type A services.
It’s a self-funded program in which you are reimbursed based on a percentage of dollars spent for dental services provided. It allows you to receive treatment from the dentist of your choice.
Under a Discount Dental Plan or DDP, a group of dentists agrees to provide services at specified discounted charges. It’s not a dental insurance plan. You directly pay the discounted fee to the dentist for the services you receive.
It’s a dental condition that usually happens after extraction of a permanent tooth and blood clot fails to appear or dissolves before the wound is healed. It’s also known as alveolar osteitis.
