Predetermination of Benefits. Predetermination of Benefits should be requested if the cost of the recommended treatment Plan exceeds Two Hundred Fifty Dollars ($250). DDPOK will issue an estimate of benefits regarding the Attending Dentist Statement (claim form) when satisfied that the patient is eligible for Benefits. The Predetermination will be for a maximum period of three hundred sixty-five (365) days from the date of Predetermination by DDPOK (one hundred eighty [180] for Periodontal procedures), but not longer than the period this Plan is in effect.
Appears in 2 contracts
Samples: Administrative Services Agreement, Administrative Services Agreement
Predetermination of Benefits. Predetermination of Benefits should be requested if the cost of the recommended treatment Plan exceeds Two Hundred Fifty Dollars ($250). DDPOK will issue an estimate of benefits regarding the Attending Dentist Statement (claim form) when satisfied that the patient is eligible for Benefits. The Predetermination will be for a maximum period of three hundred sixty-five sixty−five (365) days from the date of Predetermination by DDPOK (one hundred eighty [180] for Periodontal procedures), but not longer than the period this Plan is in effect.
Appears in 2 contracts
Samples: Administrative Services Agreement, Administrative Services Agreement
