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the company or organization which provides the dental insurance.
Carrier
The employer who purchases the plan for the employees
Policy Holder
The individual receiving dental coverage through their employer
Subscriber or Insured
The services covered by the insurance (what the plan will pay for)
Benefits
What is the annual maximum in dental insurance?
The limit to what the plan will pay out per calendar year
what is a deductible?
the amount that the patient must pay before the plan will pay benefits (a deposit)
Two carriers providing coerage for the same person
Dual coverage
What is secondary insurance?
The spouses insurance policy when you already have your own.
Which insurance is primary for children covered under both parents?
The parent whose birthday comes earliest in the calendar year.
When you obtain approval from the insurance plan before doing major treatment
Preauthorization
What is the number assigned to a company or group of employees?
Group number
What is the number signed to each employee in a group?
Identity number
What is an example of basic (Plan A) treament?
Fillings, recall exam, hygiene appointment
What is an example of major (plan B) treatment?
Crown, bridge
Would fillings fall under plan A,B or C?
A (basic)
What does it mean to file insurance claims on assignment?
The dental fofice bills the plan on the patients behalf and the patient pays only their portion of the fee at the time of service, the insurance pays the office
