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This is the tab/screen that shows the frequencies and age limits for our most common procedures.
Limitation Summary
What day is check run?
Wednesday
This type of dentist is concerned with the problems of growth and development of the teeth and jaws
Orthodontist
A tooth colored filling material composed of plastic or acrylic
Resin
This code is only covered when being performed for ortho purposes
D0470 diagnostic casts
This tab/screen will display the percentages, deductible, and wait period.
Normal claim processing time
7-14 business days
This is the category that fillings are found
Basic restorative
A tooth would most likely need a filling if this is found
Decay
Will the orthodontic max restart every benefit year?
No, this is a lifetime max
This tab/screen will show you history and payment details.
Claims
We will send the payment to the ______ if the dentist is participating with Delta Dental.
DDS/Supplier.
Surgical treatment of the mouth, jaws and face
Oral surgery
A restoration that covers a tooth to restore its size shape and function
Crown
How often are orthodontic payments made?
auto monthly
The screen that confirms the member's ID, names, DOB, & address. This screen will also show all other family members on the policy.
Verification Screen
Seeing more than one ______ will indicate that an adjustment or change has been made to a claim.
Version
Treatment of diseased peridontum
Periodontics
A nonsurgical procedure used to remove plaque and calculus from the teeth and root surfaces
scaling and root planing
We pay 50% up to $500 of this for the first payment.
Initial Banding fee
The name of all 4 systems we use.
3.0 , 2.0, HE, DCS
On the claim display page, provide the 3 colors that show and their corresponding status.
Green - final (paid or ready to pay)
Yellow - pending
Red - Denied
A professional cleaning of teeth by a dentist or hygienist.
Prophylaxis
A part of a fixed bridge which replaces a missing tooth
pontic
This service is not covered through insurance (except for 2 groups) due to the work not being in person with a licensed dentist.
Smile Direct Club