Deck 14: Dental Insurance

Question 1

A dependant on an insurance claim form refers to the:

A) spouse.
B) children.
C) employee/subscriber.
D) a and b.
E) a, b, and c.

Answer 1

a and b.

Question 2

In a coordination of benefits situation for dental insurance coverage, the primary carrier is always the carrier that provides benefits first.

Answer 2

True

Question 3

An indemnity is a fee-for-service plan and provides payment on a service-by-service basis.

Answer 3

True

Question 4

Federal guidelines require that all Medicaid patients have a right to treatment in all dental offices.

Question 5

Dental claim forms that are submitted electronically must follow guidelines set by:

A) the CDC.
B) HIPAA.
C) the ADA.
D) DANB.

Question 6

What are the consequences of sending unnecessary information when filing an insurance claim form?

A) No payment will ever be made.
B) Processing of the form will be delayed.
C) There are no consequences.

Question 7

When using the ADA code on Dental Procedures and Nomenclature to complete an insurance claim form, each code starts with a D and is followed by:

A) the dentist's initials.
B) the fee for the service.
C) four numerals.

Question 8

In the ADA Code on Dental Procedures and Nomenclature, there is no distinction between the codes for full cast high noble crown and a porcelain-fused-to-high noble crown.

Question 9

Which of the following terms is used to identify the compensation made for damage, loss, or injury?

A) Indemnity
B) Insurance
C) Introductory
D) Incomplete

Question 10

What codes and terms are published under the jurisdiction of the American Dental Association and are used for dental insurance?

A) COD
B) CDT
C) USPS
D) OSHA

Question 11

Which of the following is not required on an insurance claim form?

A) Subscriber's social security number
B) Subscriber's date of birth
C) Subscriber's group name
D) Patient's nickname

Question 12

A patient is to have treatment in the amount of $1238. The patient has a $500 deductible. This means that the:

A) subscriber must have $500 of the treatment done before the plan's benefits begin.
B) subscriber must pay $500 before the plan's benefits begin.
C) dentist must deduct $500 from the fee.
D) dentist must charge the carrier for the first $500 before services can be completed.

Question 13

A(n) ___ plan pays the provider on a monthly basis for providing dental care to patients.

A) HIS
B) HMO
C) Capitation
D) Closed panel

Question 14

Medicaid is a federally mandated dental care program for children and older adults.

Question 15

Most dental offices require the patient to submit his or her own dental claims to their insurance companies for payment.

Question 16

The term subscriber used in insurance management refers to the:

A) dentist.
B) employer.
C) male spouse.
D) employee who represents the family unit in relation to the prepayment plan.

Question 17

A denture and a crown are categorized as the same type of treatment in the ADA Code on Dental Procedures and Nomenclature.

Question 18

Dental claims are only submitted on paper.