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  • What percentage is paid at banding
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  • What codes are considered periodontal history?
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  • Can perio history be done on the same day as D4910?
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  • If the patient maxes out, do I have to follow the fee schedule?
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  • How many x-rays can we take before it converts to an FMX?
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  • What’s the appropriate time frame between perio history and D4381?
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  • Is the D9944 for bruxism (teeth grinding) only?
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  • How long do we have to file claims?
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  • Can a build up be done on the same day as a crown?
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  • What is the frequency for D9239?
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  • What amount do you require for the down payment for ortho?
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  • Will dental pay for D7240 if medical doesn't?
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  • Does oral surgery go to medical first?
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  • Do your allowed amounts follow UCR?
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  • Do you pay on prep or seat date?
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  • Can treatment be done the same day as 0140?
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  • Can SRP be done on all four quads on the same day?
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  • Does D4910 apply to the same frequency as a cleaning?
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  • What code should I use to get my claim to pay?
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  • Are there any additional benefits available for the patient?
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  • Are ortho records covered under orthodontia or preventive?
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  • Do you accept assignment of benefits?
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  • Are payments issued to the member or the provider?
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  • What is the replacement rule?
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  • How often can major services be done?
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  • Is there a missing tooth clause?
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  • Do you cover treatment in progress for ortho?
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  • What time frame should be allowed between perio history and D4910?
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  • Can scaling and root planing be done the same day as a cleaning?
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  • Do you cover services performed by a family member?
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  • Are composite fillings downgraded?
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  • Are posterior resins downgraded?
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  • Will my x-rays be returned to me?
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  • How long are dependent children covered?
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  • Can perio history be done on the same day as D4381?
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  • How do we submit a foreign claim?
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  • Does the policy allow extra benefits benefits for medical conditions?
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  • Is there a time frame between full-mouth x-rays and bitewings?
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  • How long after initial placement can we do a re-bond?
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  • Do extractions go to medical first?
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  • Is there a waiting period?
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  • Are prior extractions covered?
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  • Is periodontal maintenance "in addition" to cleanings?
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  • If a procedure is not covered, do I have to follow the fee schedule?
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  • How are ortho payments made?
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  • How do you cover the down payment for orthodontia?
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  • Do you downgrade on crowns?
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  • What is the age limitation for orthodontia?
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  • Will an alternate benefit be automatically applied to a procedure code?
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  • How long after a full-mouth x-ray can we do bitewings?
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  • How long are pre-determinations valid?
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  • Do you accept electronic claims and electronic attachments?
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  • What is paid on the initial claim for banding?
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  • If a bitewing and pano are done same day, will it convert to a full mouth x-ray?
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  • If dental services are performed because of an accident, are they covered under medical or dental?
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  • How long after initial denture placement can we do a reline?
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  • Are posterior composites downgraded?
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  • What is the group name and group number?
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  • Do you accept signature on file?
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  • Do you pay ortho in one lump sum?
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  • What is the child prophy age?
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  • Can full mouth debridement be done the same day as a cleaning?
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  • What fee schedule should we use?
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  • What is the dependent age limit?
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  • Are pre-authorizations required?
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  • Do you pay Arestin® by site or tooth?
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  • Do you require a minimum down payment for ortho?
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  • Do you cover previously extracted teeth?
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  • Does the patient have benefits for out of country provider?
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  • What is considered current periodontal charting’?
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  • Are payments for ortho treatment automatic?
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  • Does D4346 apply to the same frequency as a cleaning?
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  • Can I balance bill the patient?
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