What is a breakdown
The patients dental benefits
The patients dental history
The patients treatment plan
Can you use lower case letters in QSI?
How do you search for the insurance address when creating a new plan?
Type the insurance company name
Type + then the po box number
Enter the insurance company telephone number
What fee schedule does United Health Care (UHC) use?
United Health Care
What does FCL stand for?
Florida Central Life
Fee Change List
Florida Combined Life
When creating a new plan and the patient has an old insurance plan already attached to their account, what do you do?
999 the old plan
Cancel the old plan, use the previous days date and then attach the new plan
Replace the old plan and then attach the new plan
Who fills out the breakdown forms?
The insurance company
The breakdown department
The dental office
What is Adj Gen Svc?
What two fee schedules are added to line 11 (Plan Fee Schd) when creating a new PPO plan?
INS and Patient
INS and INS
INS and UCR
What does UCR stand for?
Usual Chart Record
Usual Customary Rate
United Core Research
If there is no deductible, what is entered on line 15 ?
U = Unlimited
If a percentage is given for implants, but the breakdown states STR, what should you do?
Example: Implants 50%-STR
Add the percentage on line 8
Do not add the percentage on line 8, but include in your comments.
Do not add the percentage or include in your comments.
What does STR stand for?
Subject to Review
Standard Treatment Review
Standard Treatment Records
It is not necessary to include orthodontics (line 11) on line 18 if blank
What is the Max Age Child?
4910 is the code for what dental procedure?
FMX, PANO and BWX are all what?
Type of X-Ray
4341 is the code for what dental procedure?
What date do you use for the Rev Date on line 4?
The date you are creating or updating the plan. You can enter "T" for today.
The previous days date. You can enter "Y" for yesterday.
What goes on line 19 for the Coverage Flag?
The office number (located in the top left corner)
Your initials and the office number
What goes on line 37 "Max $ Sched"?
The maximum amount allowed by insurance
What goes on line 3 "Plan Type"
Perio Recall is also called
If the breakdown gives a percentage for implants, but says STR, what should you do?
Do not include in comments
Do not enter the percentage, but include in your comments. Example: Implants 50%-STR
Enter the percentage, but do not include in the comments
If a max age is given for orthodontics, you should include this in your comments
If there is no deductible, what goes on line 18?
The group number does not need to go on line 1 (Plan)
All insurance fee schedules are the same
If the "Calendar Year" is circled on the breakdown, what month is used?
Where is the Toco Hills office located?
Please refer to page 1 of the sample breakdowns to answer the following question: What percent should be used for Oral Surgery?
50% and note in the comments "Oral Surgery 50/80% STR"
Please refer to page 1 of the sample breakdowns to answer the following question: The Preventative and Diagnostic percentage is 100%.
Please refer to page 1 of the sample breakdowns to answer the following question: This plan should be set up using the United Concordia PARNET fee schedule.
Please refer to page 2 of the sample breakdowns to answer the following question: The correct numbers on line 18 are...
Please refer to page 3 of the sample breakdowns to answer the following question: What fee schedule should this plan have attached?
The name of the fee schedule was not provided - an email would need to be sent back to the office for specification.
Please refer to page 3 of the sample breakdowns to answer the following question: This plan has a 5 year replace clause.
Please refer to page 3 of the sample breakdowns to answer the following question: The correct title for this plan is...
A. C. Warehouse #123456
A. C. WAREHOUSE #123456
AC WAREHOUSE #123456
Please refer to page 4 of the sample breakdowns to answer the following question: We always set up new plans for Metlife Military plans.
Please refer to page 4 of the sample breakdowns to answer the following question: The deductible applies to everything because none of the types are circled on the breakdown.
Where is the Dunlap office located?
What other offices does the FLINT office share plans with?
No other offices.
All other Michigan Offices.
What is the office number for Shady Road?
There is not an office named Shady Road.
If there are a lot of plans that are similar, it is okay to just make a new plan because that is easier and will take less time.
If an office emails the InsPlan email and tells us to update a plan without a breakdown, we just do it because they asked us to.
Diagnostic is considered to be what, on the breakdown?
What does LT mean?
If NO is circled on the breakdown next to converted, then the resins are downgraded to amalgams
Night guard is used to treat bruxism
What does crown paid seat mean?
Insurance pays on the seat date
Insurance pays only when you're wearing a crown
Insurance pays on prep date
What is TYPE II on the breakdown?