***2019***TRICARE DENTAL Flashcards Preview

*** OCCUPATIONAL REFERENCES - SEPT 2014 *** > ***2019***TRICARE DENTAL > Flashcards

Flashcards in ***2019***TRICARE DENTAL Deck (15):
1

HOW LONG MUST YOU REMAIN ENROLLED FOR

12 MONTHS

2

HOW LONG WILL FAMILY MEMBERS RECIVE BENEFITS FOR FOLLOWING SPONSORS DEATH

3 YEARS

3

DD 2813

DOD FORCES DENTAL EXAM

4

ANNUAL MAXIMUM BENEFITS

$1200 PER ENROLLE

5

LIFE TIME MAX FOR ORTHODONTIIC

$1500 PER LIFETIME

6

HOW LONG DO YOU HAVE TO SUBMIT A CLAIM

60 DAYS

7

WHAT IS NEEDED FOR A CLAIMS PROCESS

CLAIMS FORM
BILL/ STATEMENT OF CHARGES
NARF

8

BIRTHDAY RULE

DETERMINES THE FIRST PLAN TO PAY BENEFITS BASED ON WHOCH PARENTS BIRTHDAY FALLS EARLIER

9

GENDER RULE

MALE PARENTS DENTAL PLAN CONSIDERED PRIMARY

10

REPORT REQUIRED

PAID ONLY IN UNUSAL CIRCUMSTANCES

11

PERIODONTAL CHARTING REQUIRED

CHARTING SUBMITTED FOR REVIEW

12

WHAT IS COVERED IN A CONSECUTIVE 12 MONTH PERIOD

D0120 PERIODIC EXAM
D0150 COMPREHENSIVE EVAL
D0180

13

APPEALS LEVEL 1

RECONSIDERATION

FORMAL REQUEST TO SEEK SEPERATE REVIEW

14

APPEALS LEVEL 2

FORMAL REVIEW

REVIEW FROM TMA

15

APPEALS LEVEL 3

HEARING

HEARING WITH TMA OVER $300 REMAINDER

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