Dental Insurance Terms

This Financial Coordinator resource provides a document that defines insurance terms. Refer to this comprehensive list of terms and descriptions while initiating and submitting claims.

Dental Insurance Terms

Allowable charges: Maximum dollar amount on which benefit payment is based for each dental procedure.

Annual maximum benefit: Maximum dollar amount paid by the dental plan in a calendar year or plan year.

Basic care: Dental procedures to repair and restore individual teeth due to decay, trauma, impaired function, attrition, abrasion or erosion. Basic care services may include fillings (restorations), amalgam restorations, composite restorations, simple extractions, sedative fillings and maintenance prosthodontics such as denture repair, rebase, and reline.

Benefit: Amount payable by a third party toward the cost of various covered dental services or the dental service or procedure covered by the plan.

Calendar-year maximum: The maximum amount of benefits payable under the certificate in a calendar year (January 1 through December 31 of the same year).

Claim: The charges for medical/dental products and services, which are submitted by the provider or policyholder to the insurance company for review.

View the complete document and print out a copy for your office below!
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