ACCESSING BENEFITS. Participating Dentists Benefits
ACCESSING BENEFITS. Participating Dentists Benefits Anthem Blue Cross & Blue Shield will pay the lesser of fifty percent of the dentist's usual charge or fifty percent of the Usual, Customary and Reasonable Charge, as determined by us, for the dental services described in this Rider. Dentists who participate in our dental programs agree to accept our allowance as full payment and may not bill the member for any additional charges except for the remaining coinsurance balance.
ACCESSING BENEFITS. Participating Dentists Benefits When a member receives care one of over 1,800 ParticipatingDentists, he or she simply presents his or her identificationcard showing dental coverage. The dentist bills us directly for all covered services. For dental care provided by a Participating Dentist, we will pay the lesser of the dentist's usual charge or the Usual, Customary and Reasonable Charge as determined by us. The dentist accepts our reimbursement as full payment and may not xxxx the member for any additional charges. Non-Participating Dentists Benefits For covered dental services provided by a Non-Participating Dentist, in or out of we pay the lesser of the dentist's charge or the applicable allowance for the procedure, as determined by us. The member is responsible for any difference between the amount paid by us and the fee charged by the dentist. This does not constituteyour health plan or insurance policy. It is only a general descriptionfor the purposes of this Request for Proposal, of the Anthem Blue Cross Blue Shield Full Dental Plan. Refer to your Master Group Policy or Description of Benefits, on file with your employer, for a complete listing of benefits, maximums, exclusions and limitations. Decide be healthyY addition to the services provided under your dental program, the following additional basic benefits are provided: Inlays (not part of bridge) (not part of bridge) Crown (not part of bridge) Space Maintainers Oral Surgery consisting of fracture and dislocation treatment, diagnosis and treatment of cyst and abscess, surgical extractions and impaction Apicoectomy dental services listed above are subject to the following qualifications: We will pay for individual crowns, inlays and only when amalgam or synthetic fillings would not be satisfactory for the retention of the tooth, as determined by us. We will not pay for a replacement provided less than five (5) years following a placement or replacement which was covered under this Rider. We will not pay for individual crowns, or to alter vertical dimension, for the purpose of precision attachment of dentures, or when they are splinted together for any reason. If the member is not covered by Dental Amendatory Rider C (Prosthodontics) we will pay for the following types of crowns, inlays or onlays, but only when there is clinical evidence that amalgam or synthetic fillings would not be satisfactory for the retention of the tooth: One tooth on either side or two teeth on one side of a replacement f...
ACCESSING BENEFITS. Participating Dentists Benefits Anthem Blue Cross & Blue Shield of Connecticut will pay the lesser of fifty percent of the dentist's usual charge or sixty percent of the Usual, Customary and Reasonable Charge, as determined by us, for the dental services described in this Rider. Dentists who participate in our dental programs agree to accept our allowance as full payment and may not xxxx the member for any additional charges except for the remaining coinsurance balance.
ACCESSING BENEFITS. Participating Dentists Benefits When a member receives care from one of over 1,800 Participating Dentists, he or she simply present his or her Identification card showing dental coverage. The dentist bills us directly for all covered services. For dental care provided by a Participating Dentist, we will pay the lesser of the dentist's usual charge or the Usual, Customary and Reasonable Charge as determined by us. The dentist accepts our reimbursement as full payment and may not xxxx the member for any additional charges.
ACCESSING BENEFITS. Participating Dentists Benefits When a member receives care from one of over 1,800 Participating Dentists, he or she simply presents his or her identification card showing dental coverage. The dentist bills us directly for all covered services. For dental care provided by a Participating Dentist, we will pay the lesser of the dentist's usual charge or the Usual, Customary and Reasonable Charge as determined by us. The dentist accepts our reimbursement as full payment and may not xxxx the member for any additional charges. Non-Participating Dentists Benefits For covered dental services provided by a Non-Participating Dentist, in or out of Connecticut, we pay the lesser of the dentist's charge or the applicable allowance for the procedure, as determined by us. The member is responsible for any difference between the amount paid by us and the fee charged by the dentist. This does not constitute your health plan or insurance policy. It is only a general description for the purposes of this Request for Proposal, of the Anthem Blue Cross Blue Shield Full Dental Plan. Refer to your Master Group Policy or Description of Benefits, on file with your employer, for a complete listing of benefits, maximums, exclusions and limitations.
ACCESSING BENEFITS. Members must call the Member Service Center to confirm eligibility and coverage prior to consulting with any attorney. The Member Service Center will assign a Participating Attorney to provide services relative to the matter.
ACCESSING BENEFITS. For dental care provided by a participating Dentist, we pay the lesser of the dentist’s usual charge or the Usual, Customary and Reasonable Charge as determined by us. The dentist accepts our reimbursement as full payment and may not bill the member for any additional charges. The dentist bills us directly for all covered services.
