Common use of Diagnostic and Preventive Services Clause in Contracts

Diagnostic and Preventive Services. Routine Oral Exams and Consultations 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. Limited problem-focused evaluations are limited to one (1) every twelve (12) months. Consultations are diagnostic services provided by a dentist or physician other than the practitioner providing the dental treatment, and are limited to one (1) every twelve (12) months. Oral Radiographs (x-rays) Complete series intraoral x-rays or panoramic film x-rays, limited to one (1) film per lifetime for new patients only. Bitewing x-rays, limited to one (1) set every twenty-four (24) months for Members age 19 through 29, and one (1) set every three (3) years for Members ages 30 and older. Periapical intraoral films limited to four (4) every twelve (12) months and only when taken with a problem-focused evaluation or palliative emergency treatment. Oral Cleanings (Prophylaxis) Limited to one (1) every twelve (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 Emergency (Palliative) Treatment one (1) every twelve (12) months.

Diagnostic and Preventive Services. Routine Oral Exams and Consultations 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. Limited problem-focused evaluations are limited to one (1) every twelve (12) months. Consultations are diagnostic services provided by a dentist or physician other than the practitioner providing the dental treatment, and are limited to one (1) every twelve (12) months. Oral Radiographs (x-rays) Complete series intraoral x-rays or panoramic film x-rays, limited to one (1) film per lifetime for new patients only. Bitewing x-rays, limited to one (1) set every twenty-twenty four (24) months for Members age 19 through 29, and one (1) set every three (3) years for Members ages 30 and older. Periapical intraoral films limited to four (4) every twelve (12) months and only when taken with a problem-focused evaluation or palliative emergency treatment. Oral Cleanings (Prophylaxis) Limited to one (1) every twelve (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 Emergency (Palliative) Treatment one (1) every twelve (12) months.

Diagnostic and Preventive Services. Routine Oral Exams and Consultations 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 three (3) or more years. Limited problem-focused evaluations are limited to one (1) every twelve (12) months. Consultations are diagnostic services provided by a dentist or physician other than the practitioner providing the dental treatment, and are limited to one (1) every twelve (12) monthsmont hs. Oral Radiographs (x-rays) Complete series intraoral x-rays or panoramic film x-rays, limited to one (1) film per lifetime for new patients only. Bitewing x-rays, limited to one (1) set every twenty-four (24) months for Members age 19 nineteen (19) through twenty nine (29), and one (1) set every three (3) years for Members ages 30 thirty (30) and older. Periapical intraoral films limited to four (4) every twelve (12) months and only when taken with a problem-focused evaluation or palliative emergency treatment. Oral Cleanings (Prophylaxis) Limited to one (1) every twelve (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 pregnancy Emergency (Palliative) Treatment one (1) every twelve (12) months.