Predetermination of Benefits definition

Predetermination of Benefits is added:
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Predetermination of Benefits. For treatment plans costing at least $300, we recommend that your dentist submit the proposed treatment and the proposed fees to the address or fax shown above. We will send an estimate of payment to you and your dentist. Visit xxx.xxxxx.xxx to: Order/Print Dental ID card; View/Print your Dental Benefits; Access Lincoln DentalConnectSM health center for locating a dentist, dental health information and a dental cost estimator tool. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Possession of this card is not a guarantee of coverage or benefits. GLC-06995 2/11 The following provides details of the arrangement between DBP and Solstice, and your obligations to Solstice and its members:
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Examples of Predetermination of Benefits in a sentence

  • Predetermination of Benefits is a voluntary review of a Dentist’s proposed treatment plan and expected charges.

  • If there is no Predetermination of Benefits, Cigna will determine covered dental expenses when it receives a claim.Review of proposed treatment is advised whenever extensive dental work is recommended when charges exceed$500.Predetermination of Benefits is not a guarantee of a set payment.

  • If there is no Predetermination of Benefits, Cigna will determine covered dental expenses when it receives a claim.Review of proposed treatment is advised whenever extensive dental work is recommended when charges exceed $500.Predetermination of Benefits is not a guarantee of a set payment.

  • After six (6) months, a Dental Treatment Plan must be resubmitted for a new Predetermination of Benefits before treatment begins.

  • A Predetermination of Benefits is valid for six (6) months from the date it is issued.

  • All Predetermination of Benefits will be processed without taking into consideration dental benefits that may be paid under another certificate of insurance.

  • If there is no Predetermination of Benefits, Cigna will determine covered dental expenses when it receives a claim.Review of proposed treatment is advised whenever extensive dental work is recommended when charges exceed $200.Predetermination of Benefits is not a guarantee of a set payment.

  • The Predetermination of Benefits procedure will enable Delta Plan of Ohio to verify eligibility and state the amount of benefit payable by your program.

  • If a Participant submits a claim for completed treatment that includes services in the above listed categories, and benefits have not been predetermined by BCI, the claim is reviewed in the same manner as if it were being submitted for a Predetermination of Benefits.

  • If an Insured submits a claim for completed treatment that includes services in the above listed categories, and benefits have not been predetermined by BCI, the claim is reviewed in the same manner as if it were being submitted for a Predetermination of Benefits.

Related to Predetermination of Benefits

  • Coordination of Benefits or “COB” means a provision establishing an order in which plans pay their claims, and permitting secondary plans to reduce their benefits so that the combined benefits of all plans do not exceed total allowable expenses.

  • Schedule of Benefits means the section of this policy which shows, among other things, the Eligibility Requirements, Eligibility Waiting Period, Elimination Period, Amount of Insurance, Minimum Benefit, and Maximum Benefit Period.

  • Retirement Benefits means benefits paid by reference to reaching, or the expectation of reaching, retirement or, where they are supplementary to those benefits and provided on an ancillary basis, in the form of payments on death, disability, or cessation of employment or in the form of support payments or services in case of sickness, indigence or death. In order to facilitate financial security in retirement, these benefits may take the form of payments for life, payments made for a temporary period, a lump sum, or any combination thereof;

  • Death Benefit means the insurance amount payable under the Certificate at death of the Insured, subject to all Certificate provisions dealing with changes in the amount of insurance and reductions or termination for age or retirement. It does not include any amount that is only payable in the event of Accidental Death.

  • Retirement Benefit means the benefit set forth in Article 5.

  • Assignment of Benefits means an arrangement whereby the Plan Participant assigns their right to seek and receive payment of eligible Plan benefits, in strict accordance with the terms of this Plan Document, to a Provider. If a provider accepts said arrangement, Providers’ rights to receive Plan benefits are equal to those of a Plan Participant, and are limited by the terms of this Plan Document. A Provider that accepts this arrangement indicates acceptance of an “Assignment of Benefits” as consideration in full for services, supplies, and/or treatment rendered.

  • Net death benefit means the amount of the life insurance policy or certificate to be settled less any outstanding debts or liens.

  • Normal Retirement Benefit means the benefit described in Section 2.1.

  • Disability Benefit means the benefit set forth in Article 8.

  • retirement annuity contract means a contract or scheme approved under Chapter III of Part XIV of the Income and Corporation Taxes Act 1988;

  • Disability benefits means any cash payments which are payable to a covered individual for all or part of a period of disability pursuant to P.L.1948, c.110 (C.43:21-25 et al.).

  • Termination Benefit means the benefit set forth in Article 7.

  • Net Benefits Test means a calculation to determine whether the benefits of a reduction in price resulting from the dispatch of Economic Load Response exceeds the cost to other loads resulting from the billing unit effects of the load reduction, as specified in Operating Agreement, Schedule 1, section 3.3A.4 and the parallel provisions of Tariff, Attachment K-Appendix, section 3.3A.4.

  • Change in Control Benefit means the benefit set forth in Section 4.1 below.

  • Early Retirement Benefit means the retirement benefit payable to a member following early

  • Change in Control Benefits means the following benefits:

  • Termination Benefits means the benefits described in Section 4.1(b).

  • Lump Sum means the total sum which will have become payable to the Contractor by the Principal upon completion of the Works.

  • Primary Social Security Benefit means, with respect to any member, the primary insurance amount

  • Optional Deferral Provision means, as to any Qualifying Capital Securities, a provision in the terms thereof or of the related transaction agreements to the effect that:

  • Public benefit means making capital available, or facilitating the availability of capital, to businesses in this state that have 750 or fewer employees, the intent of which is to create or retain employment opportunities for residents of this state, stabilize or increase the tax base of this state, or support the redevelopment of facilities for use by small businesses.

  • Monthly Benefit means the monthly amount payable by Liberty to you if you are Disabled or Partially Disabled.

  • Compensation Accrued at Termination means the following:

  • Supplemental Retirement Benefit means the benefit determined under Article V of this Plan.

  • Deferred Compensation Account means the account maintained with respect to each Participant under the Plan. The Deferred Compensation Account shall be credited with Participant Deferral Credits and Employer Credits, credited or debited for deemed investment gains or losses, and adjusted for payments in accordance with the rules and elections in effect under Section 8. The Deferred Compensation Account of a Participant shall include any In-Service or Education Account of the Participant, if applicable.

  • Annuity Benefit means a benefit payable by us as described in Part VII.