Common use of Diagnostic and Preventive Services Clause in Contracts

Diagnostic and Preventive Services. Oral Exams Two periodic or comprehensive oral exams every 12 months. Once a comprehensive evaluation is paid, the Member is not eligible to undergo the same service with the same Provider, unless there is a significant change in health condition or the Member is absent from the Provider for 3 or more years. One limited problem-focused oral exam and consultations per Provider per patient per 12 months. One detailed problem-focused oral evaluation per Provider, per patient per diagnosis every 12 months. Oral Cleanings (Prophylaxis) Limited to two every 12 months. One additional cleaning during the Policy Year will be allowed for Members that are under the care of a medical professional during pregnancy.

Diagnostic and Preventive Services. Oral Exams Two periodic or comprehensive oral exams every 12 months. Once a comprehensive evaluation is paid, the Member is not eligible to undergo the same service with the same Provider, unless there is a significant change in health condition or the Member is absent from the Provider for 3 or more years. One limited problem-focused oral exam and consultations per Provider per patient per 12 months. One detailed problem-focused oral evaluation per Provider, per patient per diagnosis every 12 months. Oral Cleanings (Prophylaxis) Limited to two every 12 months. One additional cleaning during the Policy Year will be allowed for Members that are under the care of a medical professional during pregnancy.

Diagnostic and Preventive Services. Oral Exams Two periodic or comprehensive oral exams every 12 months. Once a comprehensive evaluation is paid, the Member is not eligible to undergo the same service with the same Provider, unless there is a significant change in health condition or the Member is absent from the Provider for 3 or more years. One limited problem-focused oral exam and consultations per Provider per patient per 12 months. One detailed problem-focused oral evaluation per Provider, per patient per diagnosis every 12 months. 97176EX-039 R01/21 23 Oral Cleanings (Prophylaxis) Limited to two every 12 months. One additional cleaning during the Policy Year will be allowed for Members that are under the care of a medical professional during pregnancy.