Emergency Dental Services. In a Hospital Emergency Room Accident includes an accidental injury to your sound natural teeth. Accidental injuries are those caused by unexpected and unintentional means. We cover the hospital or emergency room services and the doctor’s or dentist’s services. We cover the treatment in an emergency room for an accidental injury to your sound natural teeth or any facial fractures (or both) if the injury itself is the direct cause (independent of disease or bodily injury).
Emergency Dental Services. (2) Court ordered services that are Covered Services defined in Attachment C;
Emergency Dental Services. This Policy covers the dental expenses when required as emergency treatment and ordered by or received from a physician or licensed dentist. If you need dental treatment to repair or replace your natural or permanently attached artificial teeth because of an accidental blow to your face, you are covered for the medically necessary dental expenses you incur during your trip up to a maximum of $2,000. If you need emergency treatment to relieve dental pain, you are covered for the dental expenses you incur during your trip for such relief, up to a maximum of $350, and the complete cost of prescription drugs (limited to a supply of 30 days).
Emergency Dental Services. Those services necessary for the treatment of any condition requiring immediate attention for the relief of pain, hemorrhage, acute infection, or traumatic injury to the teeth, supporting structures (periodontal membrane, gingiva, alveolar bone), jaws, and tissues of the oral cavity.
Emergency Dental Services. Treatment of a potentially life-threatening dental emergency to stop ongoing tissue bleeding, alleviate severe pain or infection. Some examples of dental emergencies provided by ADA include: • Uncontrolled bleeding; • Cellulitis or soft tissue infection with swelling that potentially compromises a patient’s airway; • Trauma to facial bones that may obstruct an airway and make breathing difficult; • Tooth or jaw pain.
Emergency Dental Services. Treatment of a potentially life-threatening dental emergency to stop ongoing tissue bleeding, alleviate severe pain or infection. Some examples of dental emergencies provided by ADA include: • Uncontrolled bleeding; • Cellulitis or soft tissue infection with swelling that potentially compromises a patient’s airway; • Trauma to facial bones that may obstruct an airway and make breathing difficult; • Tooth or jaw pain. Essential Health Benefits (EHB) –are, for the purposes of this coverage, pediatric dental services that Alliant is required to cover under the Patient Protection and Affordable Care Act and any other applicable regulations. EHB and its provisions apply to Members through age 18 only. Provider – is any Physician, health care practitioner, pharmacy, supplier or facility, including, but not limited to, a Hospital, clinical laboratory, Ambulatory Surgery Center, Retail Health Clinic, Skilled Nursing Facility, Long Term Acute Care facility, or Home Health Care Agency holding all licenses required by law to provide health care services. Plan – refers to the Alliant Health Plans’ SoloCare medical health insurance plan you have chosen for the 2022 Calendar year.
Emergency Dental Services. Emergency dental coverage is limited to the emergency treatment of injury to natural teeth. Treatment includes but is not limited to x-rays and emergency oral surgery to temporarily stabilize the enrollee. Dental services provided for the routine care, treatment, or replacement of teeth or structures are not covered under this Contract.
Emergency Dental Services. Treatment of a potentially life-threatening dental emergency to stop ongoing tissue bleeding, alleviate severe pain or infection. Some examples of dental emergencies provided by ADA include: • Uncontrolled bleeding; • Cellulitis or soft tissue infection with swelling that potentially compromises a patient’s airway; • Trauma to facial bones that may obstruct an airway and make breathing difficult; • Tooth or jaw pain. Essential Health Benefits (EHB) –are, for the purposes of this coverage, pediatric dental services that Alliant is required to cover under the Patient Protection and Affordable Care Act and any other applicable regulations. EHB and its provisions apply to Members through age 18 only. Provider – is any Physician, health care practitioner, pharmacy, supplier or facility, including, but not limited to, a Hospital, clinical laboratory, Ambulatory Surgery Center, Retail Health Clinic, Skilled Nursing Facility, Long Term Acute Care facility, or Home Health Care Agency holding all licenses required by law to provide health care services. Plan – refers to the Alliant Health Plans’ SoloCare medical health insurance plan you have chosen for the 2022 Calendar year. DENTAL PROVIDERS AND CLAIMS PAYMENT You have the freedom to choose the Dentist you want for your dental care. However, your choice of Dentist can make a difference in the benefits you receive and the amount you pay. You may have additional out-of-pocket costs if your Dentist does not accept the reimbursement amount determined by Alliant. Payments are made by Alliant only when the Covered Services have been completed. Your Plan may require additional information from you or your Provider before a claim can be considered complete and ready for processing. In order to properly process a claim, your Provider may be requested to submit a corrected claim. For example, if your Dentist submits a claim for an adult dental cleaning when the service performed was a pediatric dental cleaning, Alliant will deny the claim and request that the dentist submit a corrected claim. Duplicate claims previously processed will be denied. This section describes how Alliant determines the amount of reimbursement for Covered Services. Reimbursement for dental services rendered by a Dentists is based on the Maximum Allowed Amount for the type of service performed. The Maximum Allowed Amount is the maximum amount of reimbursement Alliant will pay for Covered Services, as defined in this Schedule, by a Dentist or Member....
Emergency Dental Services. 5. Dental expenses you incur while on your trip for a direct accidental external blow to the mouth requiring the repair, extraction, replacement and treatment of sound natural teeth or permanently attached artificial teeth, to a maximum of $2,000 per accident. You must see a physician or dentist immediately following the accident. You are also covered for continuing treatment after your return to your Canadian province or territory of residence provided:
Emergency Dental Services. The Insured (or Authorized Third Party) Contacts the Insurer’s Information Service Immediately (except for notification delay due to objective circumstances) at – (+000) 000 000 000) . Expenses for medical services received without notice are not reimbursed. When applying to the provider medical institution, the insured must present an insurance policy and an identity document; In this case, the insured is exempt from paying for the relevant service. If the insured is in a non-provider medical facility, the insurer reserves the right to transfer the insured to a contractor medical facility. If the medical service is provided in a non-provider medical institution, the insured pays the full cost of the medical service and submits the documentation to Insurance Case Regulation Service of JSC New Vision Insurance, which decides on the issue of compensation in accordance with the submitted documents and the terms of the agreement. The documentation must be submitted within 30 (thirty) calendar days after the occurrence of the insured accident. The company reserves the right not to reimburse the cases for which the documents will be submitted after the expiration of this period. Documents can be submitted both in person and electronically at the company's compensation office;
