Dental Insurance Terms

Question 1

Balance Billing

Answer 1

billing a patient for the diff between the dentist’s actual charge and the amount reimbursed under the patient’s dental benefit plan

Question 2

Co-Payment

Answer 2

beneficiary’s share of the dentist’s fee after the benefit plan has paid

Question 3

Coverage

Answer 3

Benefits available to an individual covered under a dental benefit plan

Question 4

Deductible

Answer 4

co-insurance; the amount the patient is responsible for paying before services are covered by their insurance plan

Question 5

HMO

Answer 5

has dentist/provider name on the insurance card

Question 6

PPO

Answer 6

can go to any dentist who accepts that dental plan

Question 7

In-Network

Answer 7

patient pays less out of pocket

Question 8

Out-Of network

Answer 8

patient pays more out of pocket

Question 9

Flexible Spending Acct

Answer 9

Employee reimbursement acct primarily funded w/employee designated salary reductions

Question 10

HIPPA

Answer 10

Health Insurance Portability & Accountability Act of 1996

Question 11

Health Insurance Portability & Accountability Act

Answer 11

federal law that requires all health plans, who transmits health information in an electronic transaction, to use a standard format.