Prevailing Fee definition

Prevailing Fee means the most commonly charged fee for a particular procedure in the geographic area or population center where covered dental services are provided, so long as it is not less than the average fee for Primary insurance is the insurance carrier or third party payee that pays for services rendered to a covered person before any other carriers would. Prophylaxis is a professional cleaning to remove plaque, tartar (calculus), and stain from teeth to help prevent dental disease. Pulpotomy is a partial removal of the pulp. Radiograph is the photographic representation of opaque objects produced by the action of ionizing radiation upon sensitized plate or film. Also known as x-ray or digital image. Root canal therapy is the treatment of a tooth having a damaged pulp; usually performed by completely removing the pulp, sterilizing the pulp chamber and root canals, and filling these spaces with inert sealing material. Sealant is a thin plastic material used to cover the biting surface of a tooth to prevent tooth decay. Secondary insurance is the insurance carrier or third party payee that would process its payment for a claim after a primary carrier made payment, and make any additional payments as necessary. Single Procedure means a dental procedure to which a separate procedure number has been assigned. (See Article X Procedure Codes and Nomenclature of this Contract.) Space maintainer is a mechanical or prosthetic device used to prevent the drifting of teeth in an area where there has been premature loss of a tooth or teeth. Special Enrollment Period means the 30 day period of time after each of the following events during which an eligible employee can enroll eligible persons under this contract:
Prevailing Fee means a charge for Dental Expense which does not exceed the 90th percentile of the Plan’s prevailing health care data.
Prevailing Fee means a charge for Dental Expenses that does not exceed the 90th percentile of the Plan’s prevailing health care data.

Examples of Prevailing Fee in a sentence

  • If a Subscriber or other participant obtains treatment from a dentist who has not signed a participating agreement with Delta Dental, any benefit payment will be paid directly to the Subscriber, or to other participant if required by law, and will be based on the dentist’s submitted fee for his or her service or the Prevailing Fee, whichever is less.

  • If Covered Services are provided by a Dentist who has not signed a participating agreement with Delta Dental, the Plan will pay its Benefits directly to the Eligible Person, or to other participant or beneficiary as required by law, at the applicable Percentage of the Allowable Charge specified in the Schedule of Benefits based on the Dentist’s submitted fee for his or her service or the Prevailing Fee, whichever is less.

  • Prevailing Fee - the fee for a Single Procedure that satisfies the majority of Delta Dental PPO Dentists, as determined by Delta Dental based upon confidential fee listing accepted by Delta Dental from Delta Dental PPO Dentists.

  • The Township shall participate in a Health Benefits program to provide for Hospital, Surgical, Prevailing Fee and Major Medical Benefits Coverage.

  • The Company agrees to pay 85% of the premiums for Prevailing Fee and Major Medical for active employees after ninety (90) days of employment and for those on pension, until the end of the month in which the employee or pensioner attains age 65, who authorizes payroll deductions for that purpose.

  • The Township shall participate in a Health Benefits program to provide for Hospitalization, Surgical, Prevailing Fee and Major Medical Benefits Coverage.

  • Maintain enrollment in the applicable classifications (individual, family, etc.) in the Indemnity program of Blue Cross/Blue Shield, Major Medical (a maximum of $1,000,000 with a $200 deductible for the life of the agreement) Prevailing Fee program.

  • The District shall continue to provide Blue Shield Dental, Prevailing Fee, Basic plus Option A, B, C, D Dependent Coverage.

  • The Board shall provide the Delta Dental Plan, 100% Prevailing Fee, and the Delta Basic Dental Supplemental Program (including Oral Surgery, Prosthetics and Periodontics, but not including Orthodontics) or its equal (understood not to mean “identical”) for all employees and their eligible family members.

  • The Township shall participate in a Health Benefits program to provide Hospital, Surgical, Prevailing Fee and Major Medical benefits coverage.


More Definitions of Prevailing Fee

Prevailing Fee means a charge for Dental Expense that is the lesser of the fee assessed by the attending dentist, or a Dental Expense that does not exceed the 90th percentile of the Usual and Customary dental care schedule.
Prevailing Fee means the fee for a Single Procedure which satisfies the majority of Dentists in California, as determined by Delta Dental.
Prevailing Fee is the fee for a Single Procedure which satisfies the majority of Dentists in California, as determined by Delta based upon confidential fee listings accepted by Delta from Participating Dentists.
Prevailing Fee. The original amount of fee payable by the OC for the provision of the Services under this Scheme. “RI” means a registered inspector as defined in the Buildings Ordinance (Cap.123 of the Laws of Hong Kong) who is qualified to perform the duties and functions of inspectors in accordance with the said Ordinance. “Services” means the services to be provided by URA to the OC under This Scheme in respect of the Building in organizing the Building Rehabilitation Works as more particularly described in Schedule I hereto.