A ______________party administrator can describe reasonable fee as a determination that a particular service for a given procedure has been modified to take into consideration unusual complications.
The primary use of the CDT _______________is to identify and define the various transaction codes.
A ______________reimbursement is paid from a fund established by an employer.
___________________ coverage can be described as the total dollar amount an insurance company will pay during the year.
_________________ of benefits is the term used to describe how duel coverage is used to cover the cost of treatment.
______________ benefits describe health insurance that is available for purchase for a maximum of 18 months after loss of group benefits.
An ______________program is a program in which a patient receives an approved type and frequency of preventative care; the percentage is raised until covered at 100%.
Members of EPOs, HMOs, and Managed Care Plans may receive treatment only from ______________ dentists.
Check eligibility _______________—it is not uncommon for employers to change their dental coverage yearly.
Down
According to the birthday ______________, the insurance of the parent whose birthday comes first in the year is considered primary.
For a ______________dependent, the holder of the dental benefits is the subscriber.
Follow up on any ______________ insurance claims within 30 days of submission.
The deductible is a ______________, predetermined amount that a patient must pay toward treatment before his/her dental care provider will consider payment for additional services.
The ______________ rule determines the primary and secondary coverage of a child by designating primary coverage to the father and secondary coverage to the mother.
A dental clinic provided by a large corporation for employees and their families is a_____________ panel program.
A ______________ quickly supplies the patient with the needed insurance information to bill the insurance company directly for services.
Work-related ______________ are billed to workers’ compensation.
Fraudulent insurance billing , An increase in fee because the patient has insurance, is an example of overbilling. Waiver of copayment is a component of ______________.
The ______________ should be placed in a file for the month in which the claim was paid.
A ______________fee schedule establishes a set fee, regardless of geographic area. When the dental practice’s usual fee is higher than its fixed fee, the patient cannot be charged for the difference.
Electronically submitted claims turn around more quickly (usually within 1 to 2 _____________) than paper claims (approximately 1 week).
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