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Dental insurance covers many procedures for patients. It benefits dentists since they could attract patients in their insurance networks. Though, patients and dentists must be aware of premiums, deductibles, copayments, and coinsurance. Patients must pay premiums and deductibles to utilize their benefits. Premium “is the...

The Usual Customary and Reasonable (UCR) charge determines “the amount both [the patient] and [his or her] plan will contribute” within an out-of-network clinic (Ellis 2017). Dental insurance companies can determine the UCR within an area by “[recording] the fee numbers submitted by the practitioners...

Some patients cannot afford certain dental treatments and services. Others do not visit the dentist at all. Even with dental insurance, patients still have to pay out-of-pocket for some treatments. Dental offices could offer discounts for these patients, but they should still raise their fees...

While the dental clinics’ staff must use CDT codes correctly on their claim forms, the staff may also have to include narratives to these forms so that the patients receive coverage for their treatments and services (Tekavec 2000). These narratives provide more information about the...

Like their patients, clinics can choose to be in network with insurance companies. In an insurance network, clinics receive “‘free advertising’ on the insurance plan’s provider directory,” potentially attracting new patients with insurance plans (Ellis 2017). However, participating in more insurance networks does not cause...

Dental and medical insurance require different codes for their claims. Unlike dental insurance, which requires CDT codes for claims, medical insurance requires Current Procedural Terminology (CPT) codes for medical procedures and treatments and International Classification of Diseases (ICD) codes for medical diagnoses and diseases (Lupoli...

The CDT codes are important to describe procedures in claims (“Code on Dental Procedures and Nomenclature (CDT Code)”). However, Patti DiGangi, “a certified Health Information Technology trainer,” says “The existence of a code does not mean a patient has coverage under a policy. Yet without...