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9 Cards in this Set
- Front
- Back
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What is differences b/t Administrative Services ONLY and Insured?
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-Administrative Service Only (ASO): Emloyer Sponsored: Aministered by Carrier, Plan Sponsor Decisions
-Insured: Insured by carrier, Carrier Influence design |
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What is under Type I (A): Preventive?
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-Oral Examination
-Fluoride Treatment -Prophylaxis (cleaning) -Sealants -X-rays |
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What is under Type II (B) Basic?
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-Oral Surgery
-Fillings -Endodontics -Periodontics |
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What is under Type III (C) Major?
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-Prosthetics (Bridges,Dentures)
-Crowns, Inlays, Onlays, Implants |
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What are things patients understand?
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-Deductibles & coinsurance
-Plan dollar maximums |
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What are things patients don't understand?
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-Waiting period
-Lists of services (open or closed) -Benefit frequency limits/exclusions -Contract language-Incurred Expense -Administrative guidelines |
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What are things carriers do to manage costs?
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-Plan Design
-Networks -Systems & Administration -Claim Review |
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Employee and dentist education delivering tools and information to help promote what?
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-Promote better choices by participants for maintiaining oral health
-Minimize or control healthcare costs through healthier employees and research-based plan deisngs -Increased employee satisfaction w/ dental benefits, which promotes job satisfaction and loyalty. |
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What is the purpose of the MetLife Dental Advisory Council?
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-Provides professional guidance on the developmentof practice model
-Sponsors development of Quality Resources Guides -Develop dentist and pt. education programs -Serves as conduit for better dentist-pt-carrier relationship |
