Deck 5: Financing of Dental Care

Question 1

The federal and state governments' joint program that funds dental care for certain individuals is called ________.

A) Title XX
B) Title XVIII
C) Title XI
D) Title XIX
E) None of the above

Answer 1

Title XIX

Question 2

Contractual agreements between practitioners and their insurers to provide dental care services for lower-than-average fees are ________.

A) Dental Service Corporation
B) Dental Health Care Organization
C) Dental Managed Care
D) Preferred Provider Organization
E) None of the above

Answer 2

Preferred Provider Organization

Question 3

The delivery of dental care in the United States is mostly a private sector endeavor.

Answer 3

True

Question 4

The federal government funds dental care for which of the following target populations?

A) Veterans with service-connected disabilities
B) Military personnel
C) Inmates
D) Native Americans
E) All of the above

Question 5

Which system is used when a dental provider contracts with a program to provide all or most dental services to the program's subscribers in return for payment on a per-capita basis?

A) Barter
B) Encounter
C) Capitation
D) Fee for service
E) All of the above could fit this definition.

Question 6

Federal block grants are usually utilized as preventive block grants and may cover dental services for children.

Question 7

A federal insurance program to pay for medical bills of all people over age 65 is called ________.

A) Medicare
B) Medicaid
C) CHIPs
D) UCR
E) None of the above

Question 8

What is the amount that the insurance entity will pay for covered dental services?

A) Benefit
B) Provider fee review
C) Deductible
D) Prepaid group entitlement
E) None of the above

Question 9

What form describes benefits to the patient and the provider with accompanying payment or denial of payment?

A) Dental Fee Slip
B) Utilization Review Form
C) Dental Claim Form
D) Explanation of Benefits
E) None of the above

Question 10

What is the term for the arrangement when fees for services may be decreased depending on the patient's income and family's size?

A) Federal standards
B) Federal indemnity standards
C) Sliding scale
D) Customary
E) None of the above

Question 11

A portion of the cost of each service that is paid by the patient is termed ________.

A) Copayment
B) Utilization review
C) Premium
D) Capitation
E) None of the above

Question 12

Which payment method is a fee scale per service developed for each service rendered?

A) Capitation
B) Encounter
C) Barter
D) Fee for service

Question 13

State governments generally fund dental services for inmates of federal prisons within their state.

Question 14

Funding for public water fluoridation usually falls under the auspices of the local government.

Question 15

Local governments may be involved in funding dental care to which target population(s)?

A) Schoolchildren
B) Inmates at a nearby federal prison
C) Military personnel
D) Both A and B
E) None of the above

Question 16

What form is used when a dental provider bills for dental procedures rendered?

A) Dental Fee Slip
B) Explanation of Benefits
C) Dental Claim Form
D) Utilization Review Form
E) None of the above

Question 17

What are legal entities organized for individual participating dental providers to enter into contracts collectively to provide prepaid dental services?

A) Preferred Provider Organizations
B) Dental Managed Care
C) Dental Service Corporations
D) Individual Practice Associations
E) None of the above

Question 18

Which system is used when a patient and a dental provider negotiate payment by exchanging goods and services?

A) Capitation system
B) Barter system
C) Fee-for-service system
D) Encounter system
E) None of the above

Question 19

What is the range of fees charged by dental providers with similar training and service within a specific and limited geographic area?

A) Customary
B) Regular
C) Usual
D) Reasonable
E) None of the above

Question 20

A plan that uses the fee-for-service payment method and operates by means of a submittal-and-reimbursement method is called ________.

A) Utilization review
B) Deductible
C) Indemnity
D) Capitation
E) None of the above

Question 21

Medicaid, not Medicare, generally funds dental care for the indigent population.

Question 22

Choose the item that best matches each item of the following
The number given to a specific procedure as designated in the ADA Codes on Dental Procedures and Nomenclature.

A)Premium
B)Procedure numbers
C)Copayment
D)UCR
E)Procedure codes
F)Dental necessity
G)EPSDT

Question 23

Choose the item that best matches each item of the following
A service provided by a dental provider that has been determined as a generally acceptable dental practice based on the individual's diagnosis.

A)Premium
B)Procedure numbers
C)Copayment
D)UCR
E)Procedure codes
F)Dental necessity
G)EPSDT

Question 24

Choose the item that best matches each item of the following
The monthly amount due to the insurance entity by the group or the individual.

A)Premium
B)Procedure numbers
C)Copayment
D)UCR
E)Procedure codes
F)Dental necessity
G)EPSDT

Question 25

Choose the item that best matches each item of the following
The fee that reflects the average dental provider fee per service.

A)Premium
B)Procedure numbers
C)Copayment
D)UCR
E)Procedure codes
F)Dental necessity
G)EPSDT