Dental Insurance Verification

1234567891011121314151617181920212223242526272829
Across
  1. 2. Number Identifies the employer plan or group the patient belongs to
  2. 4. Year 12-month period insurance coverage follows (may not be calendar year)
  3. 6. Back Act of inputting verified benefits into the practice management system
  4. 8. Verification Method involving direct phone contact with the payer
  5. 10. Type Classification such as PPO, HMO, or Fee-for-Service
  6. 13. Covered individual other than the subscriber
  7. 14. Limitation Benefit rule that restricts coverage based on patient’s age
  8. 15. Verification Method of receiving benefit breakdown from insurance
  9. 17. Required proof of verification in the patient’s chart
  10. 18. Services Procedures the insurance will pay for
  11. 20. Limitation Rule that limits how often a service is covered (e.g., 2 per year)
  12. 21. The policyholder of the dental insurance
  13. 23. Approval required before performing certain procedures
  14. 24. Portal Online system used to verify coverage and benefits
  15. 25. Health Maintenance Organization – requires referrals and PCP selection
  16. 27. Form Standardized form used to record insurance benefit info
  17. 28. Descriptions written to explain necessity of procedures
  18. 29. Period Timeframe before certain services are eligible for coverage
Down
  1. 1. Patient’s percentage of the allowed amount
  2. 3. Preferred Provider Organization – offers in- and out-of-network options
  3. 5. Check Step to confirm if a patient is covered on the date of service
  4. 7. Date The date coverage starts
  5. 9. Fixed dollar amount the patient pays at the visit
  6. 10. Written estimate of benefits for proposed treatment
  7. 11. Services Procedures not paid by the plan at all
  8. 12. Maximum The total amount insurance will pay in a benefit year
  9. 13. Amount the patient must pay before insurance pays
  10. 16. Breakdown Document listing covered services and limitations
  11. 19. Verification The process of confirming a patient’s active dental coverage
  12. 22. Date The date coverage ends
  13. 26. Tooth Clause Exclusion for tooth loss prior to coverage