Common use of Predetermination of Benefits Clause in Contracts

Predetermination of Benefits. If a course of treatment is expected to involve charges for dental services in certain categories of care such as Periodontics, Endodontics, Special Services, Prosthetic Services or Orthodontics of $300 or more, it is recommended that a description of the procedures to be performed, an estimate of the dentist's charges and an appropriate x-ray pertaining to the treatment, be filed by the dentist with us in writing, prior to the course of treatment.

Predetermination of Benefits. ‌ If a course of treatment is expected to involve charges for dental services in certain categories of care such as Periodontics, Endodontics, Special Services, Prosthetic Services or Orthodontics of $300 or more, it is recommended that a description of the procedures to be performed, an estimate of the dentist's ’s charges and an appropriate x-ray pertaining to the treatment, be filed by the dentist with us the Plan Manager in writing, prior to the course of treatment.