Payments
The tool used to take credit card payments
PCI Pal Token Generator
PI210
FI315
SEL 55 I
Individual HMO Plans
$1.00
$.075
Administrative Fee and Monthly association fee
Legal spouse
Adopted Children
Common law
Qualified dependents
D7210, D7220, D7250
Extraction Codes
The F key to see premium reconcilliation history Inquiry screen
Shift F7 Shift F9
PS220
CS150
FS305
Plus Plans
D2740*
Crown + Lab fee
No ACH or credit card information is ever included on the enrollment form.
Policy Conversion Involving a Loyalty Plus Product
D0330
D0274
D0210
Xrays
The F Key and steps used to view billed to date
Shift F7 Enter Enter or
Shift F7 Press Enter Button Twice
TDP
DDP
Discount Plans
$35.00 one time
Enrollment fee
By the close of the business day
7-10 calendar days
Turn Around Time Expectations(CompBenefits)
D6240
D6250
Bridges
09, 13, 16, 08
Bill Form Format Codes
INDTN7
Tenessee Preventive Plus Plan
Sometimes paid with copays
supplements
Complete and mail to
Florida Combined Life
PO Box 769569
Roswell GA
Policy Conversion for FCL Members
D4341
D4342
Periodontal Scaling and root planning
DEPE
ATC
MTB
CDGN1N
Complete Dental
Must be paid at each visit with or without services
Office Visit copay
January 11th
February 10th
May 11th
March 02nd
Billing Cycle Dates for IA Products
D2391
D2161
D2160
D2394
Fillings