D0180 - Comprehensive periodontal evaluation.Forms of fraud - Upcoding and misrepresentation of services rendered.Potential for fraud - If the dentist actually performs a dental prophylaxis (prophy), but files the claim for 4 quadrants of scaling and root planing.D4341/4342 - Periodontal scaling and root planing.Some examples of specific dental codes that may involve acts of fraud: What do I do if I suspect or become aware of an example of dental fraud or abuse?.What are we doing about dental fraud and abuse?.What can stop or reduce dental fraud and abuse?.Some examples of specific dental codes that may involve acts of fraud:.What does an act of dental fraud look like?.With your help, we can all benefit from prevention of fraud and abuse. Please email us at If you have any questions about our fraud and abuse program or about submitting claims correctly, please feel free to call us at 80. We have an electronic mailbox to which either grievances or matters of suspected dental fraud and abuse can be forwarded. Dental plans benefit from having an active fraud and abuse program associated with them. Preventing fraudulent activities can help lower costs, form a better dental network and create higher overall satisfaction for providers, their patients and employers. (A two-year waiting period applies before you can get this coverage.Prevention and detection of fraud and abuse is in everyone's best interest. 60% reimbursement for orthodontic services, up to a lifetime maximum of $1,500.(A one-year waiting period applies before you can get this coverage.) 50% reimbursement for major restorative dental care with a $500 annual maximum.(A 3-month waiting period applies before you can get this coverage.) 80% reimbursement for preventive dental care with a $750 annual maximum.You can also opt in to have dental coverage in a Standard or Enhanced personal health insurance plan.Ī Standard plan comes with 70% reimbursement for preventive dental care with a $750 annual maximum. (A 3-month waiting period applies before you can get this coverage.) Learn more about dental insurance.
It includes 60% reimbursement for preventive dental care with a $500 annual maximum. Does personal health insurance cover dental care?ĭental coverage is included with a Basic personal health insurance plan.
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