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With indemnity dental plans, the insurance company generally pays the dentist a percentage of the cost of services. Restrictions may include the co-payment requirements, waiting period, stated deductible, annual limitations, graduated percentage scales based on the type of procedure, and the length of time that the policy has been owned.
While SHOP was available for 2014, this is the first year that small employers in 14 states can apply online. Before 2015 employers who provided health insurance to their employees typically worked with an insurance broker and one health insurance company. In 2015, they however can offer their employees a choice of insurance companies.
The Commission on Dental Competency Assessments (formerly the North East Regional Board of Dental Examiners) is one of three examination agencies for dentists in the United States. [1] These were organized to better standardize clinical exams for licensure. Historically each state had its own independent licensing exam.
The Canadian Dental Care Plan is a dental insurance program funded by the Government of Canada to provide dentistry services to uninsured Canadians that meet certain criteria. [1] It replaces a temporary dental benefit program established in 2022 for children under 12 who did not have dental insurance coverage, which was terminated in June 2024.
Universal numbering system. This is a dental practitioner view, so tooth number 1, the rear upper tooth on the patient's right, appears on the left of the chart. The Universal Numbering System, sometimes called the "American System", is a dental notation system commonly used in the United States. [1] [2]
Adjustment of claims is not confined to claims against insurance companies. An allowance made by a creditor, particularly a storekeeper, in response to a complaint by the debtor respecting the accuracy of the account or other claim, or a reduction in the claim or account made to induce a prompt payment, is in a proper sense an adjustment. [2]
An additional transaction may also be payable to cover e.g. costs for revised insurance documents. Some insurers also use this fee to discourage changes, although few openly admit this. A cancellation is often treated as a special-case MTA, where the cover decreases to zero. Such transactions may attract special fees too.
A prospective payment system (PPS) is a term used to refer to several payment methodologies for which means of determining insurance reimbursement is based on a predetermined payment regardless of the intensity of the actual service provided. It includes a system for paying hospitals based on predetermined prices, from Medicare.