Midterm Exam Review Flashcards
How much free space should be left on each shelf of a filing cabinet?
Leave atleast 4 inches of working space on each shelf or in each drawer.
What is used to mark a space from which a record has been taken?
Outguide - like a bookmark
Which filing system is easiest to use?
Alphabetical - easiest and most commonly used for filing paper records
If a patient was seen in 2019, would that patient be considered active or inactive?
Inactive (active have been seen in the past 2-3 years)
Define Subscriber
Person who carries the insurance and also the person receiving the treatment
Define Carrier
The insurance company who pays the claims and collects premiums
Define Dependent
Person who receives the treatment and is the child or spouce of the subscriber
Define Group
The union or employer that has purchased or arranged insurance as a benefit
Define Provider
The dentist who provides treatment to the patient
What is the Birthday Rule
When a child is covered under both parent’s plans, the plan of the parent whos birthday falls first in the calendar year (dd/mm) is billed first.
Define Primary Carrier
Insurance company (carrier) that pays first
Define Secondary Carrier
Insurance company (carrier) that pays second
Least expensive alternative treatment
Least expensive alternative treatment is a limitation in a dental plan that allows for the least expensive treatment. Patient needs to replace a missing tooth. Treatment options are a fixed bridge for $4000 or a partial denture for $2500. Under LEAT the carrier will pay the benefits for a partial denture only. If the patient decides on the fixed bridge the patient MUST pay the difference in cost.
Define Schedule of benefits
A list of fixed specified amounts that a carrier will pay towards the cost of covered services.
Define Deductible
Amount of money each enrollee or family must pay before insurance will pay for covered services. Usually $25 to $50 per year.
Define Exclusive provider organization
Closed panel where a patient must see the dentist who is a member of the plan’s network of providers
Define Annual Maximum
12 month period of the dental contract (not always calendar year). Most patients have a maximum allowable per year
Define Usual Fee
Fee that a dentist charges a private patient for a given service. Fees are determined by the individual dentist.
Define Waiting Period
Period between employment and the date that the employee becomes eligible for benefits
Define Coordination of Benefits
Patient or dental office will receive payment from both carriers but the total received will not exceed 100% of the actual dental expense.
Define Indemnity plan
Traditional dental insurance plan.Provides benefits for dental treatment that a covered individual receives from their own dentist.
Define fixed fee schedule
An established fee for any treatment received by the patient. Under government programs the dentist must accept the payment from the carrier as payment in full and can not bill the patient the difference.
What is accounting?
process of recording, classifying, and summarizing financial transactions
What does accounts receivable manage?
the money owed to the practice
