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 tax-advantaged savings account that you can open to pay for qualified dental and other medical expenses. You and your employer can put money in this account. The funds in this account belongs to you. The account goes with you if you change your job.
A tooth that is limited by bone or soft tissue from breaking through your gums.
It’s repetitive. Remove it.
A restoration fabricated outside the mouth.
Person covered by a dental insurance plan (you).
It’s repetitive. Remove it.
It’s a category of dental services that usually covers crowns, dentures, implants and oral surgery. Copayments or coinsurance is typically higher for these services. Also called Class III, Group III or Type C service.
It’s a type of health insurance plans in contract with health care providers to receive services at reduced costs.
It’s repetitive. Remove it.
