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  2. Current Dental Terminology - Wikipedia

    en.wikipedia.org/wiki/Current_Dental_Terminology

    In addition, payment to dental professionals is based on the CDT code(s) reported on the ADA Claim Form, so using the most current codes helps to maximize reimbursement and minimize audit liability. [6] In the near future, dental professionals will be required to use diagnosis codes in support of the procedures and services they provide.

  3. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    A medical biller then takes the coded information, combined with the patient's insurance details, and forms a claim that is submitted to the payors. [ 2 ] Payors evaluate claims by verifying the patient's insurance details, medical necessity of the recommended medical management plan, and adherence to insurance policy guidelines. [ 4 ]

  4. Dental service organizations - Wikipedia

    en.wikipedia.org/wiki/Dental_service_organizations

    Several state dental associations have attempted to introduce legislation to restrict DSOs from competing within their state. [16] [17] Associations claim that the DSO may exert pressure on dentists to do more work than what is needed, [18] despite studies that show DSO-affiliated dentists actually do less work than the average dentist.

  5. Explanation of benefits - Wikipedia

    en.wikipedia.org/wiki/Explanation_of_benefits

    An explanation of benefits (commonly referred to as an EOB form) is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf. [1] The EOB is commonly attached to a check or statement of electronic payment. An EOB typically describes:

  6. The Guardian Life Insurance Company of America - Wikipedia

    en.wikipedia.org/wiki/The_Guardian_Life...

    Guardian is the 6th largest dental provider in the US, with 6.4 million participants as of February 2015. [10] Guardian acquired First Commonwealth in 1999, [11] and acquired Premier Access in 2014, [12] and Avesis in 2016. [13]

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