Stars and Rumba
Contract H5521 - 459 has a Dental plan named ____.
Total PPO 20% Coins OON Hybrid
This Procedure involves removing a tooth
Extraction
This type of Dentist handles primary care concerns.
General Dentist.
These procedures will no longer be covered. and members will have to submit a claim prior to the start of the new year.
Implants and Orthodontics
The three types of benefit structures for indiv plans?
MSB, OSB, and Combo
In Rumba this option is used at the top of the screen to verify a providers network address.
NV
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
What type of plan will no longer be offered come 2025?
DMR
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
These are new plans being offered in 2025
Essential & Enhanced SNP
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
These four ADA codes were removed from the Aetna Enhanced Standard/Premier PPO/ESA and Aetna Premier EPO plans
D7510, D7511, D7520, and D7521
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)
This is a feature we can utilize in SCP when a member disagrees with a coverage decision we made and the standard TT would jeopardize the members' health.
Expedited Appeal
A highly trained surgeon usually performs this for conditions affecting the face, jaws, mouth, and neck. we did not know how say to Spanish (or the pronunciation in English)
Maxillofacial Surgeon
This specialist treats gum disease.
Periodontist
This particular additional benefit for members who receive extra help will not offered in 2025 through Liberty Dental.
DVH Wallet
Scheduled Benefit Plans will add these two plan types in 2025.
Essential and Enhanced SNP