Common use of Processing Policies Clause in Contracts

Processing Policies. The dental care guidelines for the DeltaCare USA plan explain to Contract Dentists what services are covered under this Contract. Contract Dentists will use their professional judgment to determine which services are appropriate for the Enrollee. Services performed by the Contract Dentist that fall under the scope of Benefits of this Contract are provided subject to any Copayments. If a Contract Dentist believes that an Enrollee should seek treatment from a specialist, the Contract Dentist contacts Delta Dental for a determination of whether the proposed treatment is a covered benefit. Delta Dental will also determine whether the proposed treatment requires treatment by a specialist. An Enrollee may contact Delta Dental’s Customer Service Center at 000-000-0000 for information regarding the dental care guidelines for DeltaCare USA.