COB
This rule determines which parent's dental insurance is primary for a dependent child when both parents have coverage, based on the calendar date of birth.
What is the Birthday Rule?
The easiest way to note if an insurance claim is still pending.
What is a Red Claim?
A 13 year old would be listed as his/her own subscriber in Open Dental due to having an individual ID# for this Insurance Carrier
What is Health Partners?
The first button you click when entering an insurance plan into a patient's chart.
What is "Pick from List?"
This promo is always line item adjusted under the office, not the provider who performed the service.
What is the Postcard Special?
When both parents share the same birth month, this factor typically determines which dental insurance plan is considered primary for a dependent child.
What is the plan that has been active the longest?
This number, found on every card, is critical for Open Dental to pull breakdown and submitting info correctly.
What is the Group Number?
Dr. Moore is redoing a filling originally placed by Dr. Curtis on 02/15/2024. The patient has excellent homecare and regular visits. This is the provider the redo adjustment should be applied to.
Who is Dr. Curtis
When an individual has dental coverage under both their own policy and their spouse's, this policy is considered primary.
What is the patient’s own policy?
This is the correct fee schedule for the pictured card.
What is Delta Premier Fee Schedule?
When an insurance will only pay for a cheaper procedure than billed and allows the provider to collect the difference between the two codes.
What is a downgrade?
This Act, signed into action in 2024, prohibits the sharing of credits between family members or collecting balances from anyone except the patient or financially responsible party.
What is the Minnesota Debt Fairness Act?
When a patient cancels last-minute, this is the fate of the break room snack stash.
What is it vanishes in record time?
What is Delta PPO Fee Schedule?
D0364/D0367 (CT) D2391-D2394 (Post Fillings), D2950 (BU), D9230 (N2O), D9944 (Occlusal Guard)
What are some specific codes to enter in the "other benefits" section of the benefits?
The universal facial expression when the schedule is completely booked, the phones won’t stop ringing, hygiene just walked up with another treatment plan, and the assistant just told you the doctor wants extra time on his next double booked slot.
What is :'‑(?
This type of secondary insurance plan only pays once the primary insurance has been fully used.
What is "carve out" or "non-duplicating?"
Looking for PMI & PMAP anywhere on the card.
What are ways to quickly spot MA plans?
TWO PART:
You know your patient's perio maintenance is typically covered, but now your account looks like this. You would look here first to see if you can figure out why and then fix it in this section.
What are the "Edit Benefits" and "Other Benefits" sections? (can describe since names probably not known)