Common use of DENTAL NECESSITY Clause in Contracts

DENTAL NECESSITY. (DENTALLY NECESSARY) means that the dental services provided by a dentist to identify or treat your dental or oral health condition, upon review by BCBSRI, are: • consistent with the symptoms and appropriate and effective for the diagnosis, treatment, or care of the oral condition, disease, or injury for which it is prescribed or performed; • appropriate with regard to generally accepted standards of dental practice within the dental community or scientific evidence; • not primarily for the convenience of the member, the member’s family or dentist of such member; and • the most appropriate in terms of type, amount, frequency, setting, duration, and level of service that can safely be provided to the member.

DENTAL NECESSITY. (DENTALLY NECESSARY) means that the dental services provided by a dentist to identify or treat your dental or oral health condition, upon review by BCBSRI, are: •  consistent with the symptoms and appropriate and effective for the diagnosis, treatment, or care of the oral condition, disease, or injury for which it is prescribed or performed; •  appropriate with regard to generally accepted standards of dental practice within the dental community or scientific evidence; •  not primarily for the convenience of the member, the member’s family or dentist of such member; and •  the most appropriate in terms of type, amount, frequency, setting, duration, and level of service that can safely be provided to the member.