Stars and Rumba
Contract H5521 - 235 has a Dental plan named ____.
Deluxe PPO Mandatory
This Procedure involves removing a tooth
Extraction
This type of Dentist handles primary care concerns.
General Dentist.
The three types of benefit structures for indiv plans?
MSB, OSB, and Combo
This option is used at the top of the screen to select a providers network affiliation.
NV (Network view)
This procedure involves removing the nerves and blood vessels
Root Canal
This type of Dentist cares for the Pulp and nerves of a patients teeth.
Endodontist
This type of benefit structure allows for coverage of all licensed providers, but requires members to submit a form after services. It also comes in either 100% or 50% coverage.
DMR
This program within Rumba is used to look up a providers fee schedule.
EPDB
Habitual clenching or grinding teeth, usually while sleeping.
Bruxism
This type of Dentist Specializes in the replacement of missing teeth or the repair of natural teeth.
Prosthodontist
This type of plan does not allow for visits to OON providers.
EPO
This keyboard combination is used to unlock Rumba when "No Editing" is displayed in the bottom left corner.
CTRL+R
A removable Prosthesis
Dentures
If you you need surgery on your mouth, jaw, or face, what type of dentist would you see?
Oral or Maxillofacial Surgeon
This type of plan can charge their normal fee, the plans payment is based on the billed amount when seeing an OON provider.
Total Choice or Choice (2025)
The feature we can utilize in SCP when a member disagrees with a coverage decision we made and the standard turnaround time could jeopardize the members' health.
Expedited Appeal
A highly trained surgeon usually performs this for conditions affecting the face, jaws, mouth, and neck.
Maxillofacial Surgeon
This Greek word means "around" and "tooth"
Periodontist
Scheduled Benefit Plans will add these two plan types in 2025.
Essential and Enhanced SNP