removal of plaque, calculus, and stain from teeth.
Schedule of Allowances
see Table of Allowances.
Schedule of Benefits
a listing of the services for which payment will be made by a third-party payer, without specification of the amount to be paid.
A security deposit in the amount of one month's premium will be held to be used in the event that automatic withdrawal is unavailable due to insufficient funds. Selecting monthly authorizes the withdrawal of this initial two (2) month premium plus the processing fee.
the method of providing employee benefits, in which the sponsor does not purchase conventional insurance, but rather elects to pay for the claims directly, generally through the services of a TPA. Self-funded programs often have stop loss insurance in place to cover abnormal risks.
setting aside of funds by an individual or organization to meet anticipated dental care expenses or its dental care claims, and accumulation of a fund to absorb fluctuations in the amount of expenses or claims. The funds set aside or accumulated are used to provide dental benefits directly instead of purchasing coverage from an insurance carrier.
dental benefit organizations established under not-for-profit state statutes for the purpose of providing health care coverage, e.g., Delta Dental Plans, Blue Cross and Blue Shield Plans.
one of the six relatively equal sections into which a dental arch can be divided, for example: tooth numbers 1-5; 6-11; 12-16; 17-21; 22-27; 28-32. Sometimes used for recording periodontal charting.
surgical procedure for the repair of a defect and/or restoration of portion of a salivary gland duct.
inspection of the salivary ducts and glands by radiograph after the injection of a radiopaque medium.
surgical procedure by which a stone within a salivary gland or its duct is removed, either intraorally or extraorally.
a term used to describe a single area, position, or locus. A single site is an area of communication that may involve adjacent teeth. All non-communicating areas are single sites.
a device used to support, protect, or immobilize oral structures that have been loosened, replanted, fractured or traumatized. Also refers to devices used in the treatment of temporomandibular joint disorders.
Statistically-based Utilization Review
a system that examines the distribution of treatment procedures based on claims information and in order to be reasonably reliable, the application of such claims analyses of specific dentists should include data on type of practice, dentist's experience, socioeconomic characteristics, and geographic location.
inflammation of the membranes of the mouth.
a general term referring to that category of coverage that provides insurance protection (reinsurance) to an employer for a self-funded plan.
that part of a tooth-borne and/or tissue-borne prosthesis designed to relieve the abutment teeth and their supporting tissues from harmful stresses.
plaster or stone model of teeth and adjoining tissues; also referred to as diagnostic cast.
the person, usually the employee, who represents the family unit in relation to the dental benefit program. This term is most commonly used by service corporation plans. Also known as: certificate holder, enrollee.
Summary Plan Description
see Benefit Plan Summary.
a stated dollar amount paid to the dentist by the beneficiary, in addition to other reimbursement received by third-party payer(s).
stitch used to repair incision or wound.