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Dent 142- Insurance Claim Forms

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