Orthodontic
Recovery
Claims
Eligibility and Benefits
QM
100
Treatment Plan extension summary
What is a truth and lending statement??
100
The 45 day grace period in which we allow for returned monies.
What is the grace period.
100
Claim denied due to extraction on the same day.
What is the incorrect denial for bone graft?
100
The replacement of a tooth extracted prior to the patient effective date of coverage
What is a MTC?
100
Unprofessional tone or demeanor displayed to a caller.
What is inflection?
200
Treatment started prior to DDIC-(Typically the patient was uninsured)
What is WIP? (work in progress)
200
The number normally used to determine specific provider recovery requested information
What is the payee id?
200
Procedure 2954 will deny if there is no history of..
What is a RCT? (root canal)
200
List of fees for a specific group
What is a TOA?
200
I will be happy to assist with that…
What is a proactive/positive statement?
300
Fixed appliance therapy
What is the code 8020?
300
Usually displayed as PPO/PPO
What is straight PPO?
400
Banding Date, Total Treatment, Proceduce Code, Downpayment amount, and Total months and monthly fee.
What are the items needed to process an Ortho Claim?
500
Repair or replacement of any appliance inserted under a Delta Dental plan is not a benefit. The fee is the patient’s responsibility.
Do we cover the Replacement of lost or broken retainer?
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