Being familiar with insurance terminology helps you better understand your dental benefits.
NCQA (National Center for Quality Assurance)
The most highly recognized accreditation organization, by insurance companies and employers, for managed care entities.
A necessary dental procedure or service as determined by a dentist, to either establish or maintain a patient's oral health. Such determinations are based on the professional diagnostic judgment of the dentist and the standards of care that prevail in the professional community.
Dentists who have contractually agreed to follow the plan's procedures.
Any dentist who does not have a contractual agreement with a dental benefits organization to render dental care to members of a dental benefits program. Also known as out-of-network dentist.
A method of payment for group coverage in which all of the monthly premium for the program is paid by the employer.