Dental Insurance Terms Quiz

What is the Annual Maximum in a dental insurance plan?

• The total dollar amount that a plan will pay for dental care for an individual member or family member for a specified benefit period

• The maximum number of dependents covered under the plan

• The maximum number of dental treatments covered in a year

• The amount a member has to pay before insurance benefits kick in

What is the meaning of Balance Billing in dental insurance?

• When a member has to pay the entire bill without any insurance coverage

• When a dentist bills a member for the full amount of the treatment

• When a participating dentist bills a member for amounts indicated as not billable to the patient by the dental insurance company

• When the insurance company pays the entire bill without any cost to the member

What is the purpose of Coordination of Benefits (COB) in dental insurance?

• To coordinate appointments with different dentists

• To determine the amount that each of the member's dental plans will pay

• To provide additional benefits to the member

• To review and update processing policies

What is the definition of a Pre-Treatment Estimate in dental insurance?

• A treatment plan submitted by a dentist for the dental insurance company to review and provide an estimate of benefits before treatment starts

• An estimate of the total cost of dental treatment after it has been completed

• An estimate of the out-of-pocket expenses for the member after treatment

• A document detailing the dental treatments and services that were paid for on a member's behalf

What is the purpose of a National Provider Identifier (NPI) in dental insurance?

• To review and update processing policies

• To provide a unique identification number for each dental treatment

• To determine the maximum amount a plan will pay over the course of a lifetime

• To identify a health care professional as an alternative to their dental license number

What is the meaning of the 100/80/50 Dental Plan?

• Preventive Services are covered at 80%, Basic Services at 50%, and Major Services at 20%

• Preventive Services are covered at 100%, Basic Services at 80%, and Major Services at 50%

• Preventive Services are covered at 100%, Basic Services at 50%, and Major Services at 80%

• Preventive Services are covered at 50%, Basic Services at 80%, and Major Services at 100%

What is the purpose of a Dental Deductible in dental insurance?

• The percentage of the costs of services paid by the patient

• The dollar amount a member must pay for covered dental services before insurance benefits will be paid to the dentist

• The maximum amount a plan will pay over the course of a lifetime

• The amount set by the dental insurance company that a dentist has agreed to charge for a service

What is the meaning of In-Network Dentist in dental insurance?

• A dentist who has agreed to be a part of the dental insurance company's network and accept pre-established fees for his or her professional dental services

• A dentist who has not signed up to participate in the dental insurance company's network

• A unique identification number used to identify a health care professional as an alternative to their dental license number

• A dentist who bills a member for amounts indicated as not billable to the patient by the dental insurance company

What is the purpose of a Processing Policy in dental insurance?

• A process designed to ensure a dentist is properly trained and licensed to treat members before becoming a part of a dental insurance company network

• A list of charges for specific dental treatments used to reimburse dentists on a fee-for-service basis

• A paper or electronic document provided by the dental insurance company detailing the dental treatments and services that were paid for on a member's behalf

• Internally developed policies used as a tool and guide to determine coverage for members

What is the purpose of Open Enrollment in dental insurance?

• The period of the year during which employees or qualified individuals can enroll in or make changes to their benefits plan

• The maximum number of dental treatments covered in a year

• The amount a member has to pay before insurance benefits kick in

• The maximum number of dependents covered under the plan