Claims Adminstration Manuals 
Author Message
 Claims Adminstration Manuals

There are something like 600 different American Dental Association
dental procedures codes.  Different dental insurance plans offer
coverage for different procedures.  For example, one plan may cover a
three surface anterior resin restoration (ADA code 2332) while another
plan may not.  I believe these coverage parameters are outlined in a
dental insurance plan's Claims Administration Manual.  (Am I correct in
this assumption?  Does a Claims Administration Manual give a thumbs up
or thumbs down for every ADA procedure code?)

My question is, do you know of any resource that compares the different
procedures covered under varying plans, as outlined in each plans Claims
Adminstration Manual?  Such a report may be used as a comparative
reference to show employee benefit managers or dentists exactly what
procedures are covered under various plans.  If you don't know of
anything like this, do you know how I could get a copy of any insurance
company's Claims Adminstration Manual?

Thank you for any help you could provide.

Tue, 17 Aug 1999 03:00:00 GMT
 [ 1 post ] 

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