Term
| DIFFERENCE BETWEEN MEDICINE AND DENTISTRY |
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Definition
| "DRS ARE HOSPITAL BASES VS DENTISTS OFFICE BASED, MANY INDIVIDUALS REQ ONLY PREVENTATIVE OR NO MEDICAL FOR YEARS WHEREAS MOST REQ ROUTINE DENTAL, DENTAL CONSIDERED ELECTIVE AND POSTPONE UNTIL PAIN OR TRAUMA, MAJOR DENTAL CARE NON LIFE THEATENING-TREATMENT CAN BE DISCUSSED IN ADVANCE, MEDICAL CARE RARELY COSMETIC WHEREAS DENTAL USUSALLY IS, DENTISTRY HAS A VARIETY OF ALTERNATIVE PROCEDURES, DENTAL COSTS GENERALLY LOWER, MORE PREDICTABLE AND BUDGETABLE, DENTISTRY EMPHASIS ON PREVENTION MORE THAN MEDICINE." |
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Term
| ORGANIZATIONS THAT PROVIDE DENTAL COVERAGES |
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Definition
| "3) BCBS ORG-DENTAL ORGS, SELF INS PLANS, GROUP PRACTICE-HMO'S" |
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Term
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Definition
| "FEE FOR SERVICE-INDEMNITY APPROACH(MOST), PREFERRED PROVIDER, DENTAL-HMO APPROACH." |
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Term
| 10 DENTAL TREATMENT CATEGORIES-GROUPINGS |
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Definition
| "a-DIAGNOSTIC, PREVENTATIVE (1ST LEVEL),b- RESTORATIVE, c-ENDODONTICS, PERIODONTICS(2ND LEVEL), ORAL SURGERY, PROSTHODONTICS, d-ORTHODONTICS, PEDODONTICS, e-IMPLANTOLOGY." |
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Term
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Definition
| "PAY A FIXED ALLOWANCE FOR EACH DENTAL PROCEDURE-ADVANTAGE INCLUDE COST CONTROL, UNIFORM PAYMENTSEASE OF UNDERSTANDING, EMPLOYEE APPRECIATION, DISADAVNTAGE-BENEFIT LEVELS MUST BE EXAMINED-CHANGED TO MAINTAIN REIM OBJECTIVES, VARY BY LOCATION DENTIST MAY ADJUST CHARGES-BALANCE BILL. " |
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Term
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Definition
| "COVER SOME % OF REASONABLE AND CUSTOMARY CHARGES, GENERALLY INCLUDE A DEDUCTIBLE. BUILT IN ADJ FOR INFLATION. DISADVANTAGE-COST CONTROL-INFLATION, BENEFIT IMPROVEMENTS ARE LIMITED, PAYMENT BY PATIENT RARELY CLEAR." |
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Term
| WHAT ARE INCENTIVE DENTAL PLANS |
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Definition
| ENCOURAGE PTPS TO VISIT DENTIST-LOWER FIRST YR COST THAN NONSCH PLANS. REIMBURSE AT A UNIFORM LEVEL DURING 1ST YR AND INCREASE IF CARE MAINTAINED IN FUTURE YRS. |
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Term
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Definition
| "NEVER WRITTEN WITHOUT DENTAL COVERAGE, ONLY ONE IN A LIFETIME-MAX, NO DEDUCTIBLES, SOME LIMIT TO UNDER 19." |
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Term
| ISSUES TO ADDRESS IN DESIGN OF DENTAL PLAN |
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Definition
| "TYPE, DEDUCTIBLES, COINSURANCE, MAXIMUMS, PREEXISTING CONDITIONS, ORTHODONTICS." |
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Term
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Definition
| "USUALLY ON A CALENDAR YEAR, SOMETIMES LIFETIME. PROMOTES EARLY OVERUTILIZATION" |
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Term
| CHARACTERISTICS OF DENTAL PLAN COST |
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Definition
| "AGES, GENDER, LOCATION, INCOMES, OCCUPATIONS" |
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Term
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Definition
| DEFERRAL OF NEEDED TREATMENT UNTIL AFTER PLAN EFFECTIVE DATE |
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Term
| SAFEGUARDS AGAINST ADVERSE SELECTION-DENTAL |
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Definition
| "COMBINING DENTAL PLAN PARTICIPATION WITH MEDICAL, LIMIT ENROLLMENT TO SINGLE OFFERING, REQ DENTAL EXAMS BEFORE JOINING-HIPAA DOES NOT APPLY, REQ PTPS TO REMAIN FOR A SPECIFIED PERIOD OF TIME" |
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Term
| PREDETERMINATION OF BENEFITS |
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Definition
| REQUIRES A DENTIST TO PREPARE A TREATMENT PLAN THAT SHOWS WORK AND COSTS BEFORE SERVICE BEGINS. |
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Term
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Definition
| "OPTHAMOLOGY,OPTOMETRY, OPTICIAN" |
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