A booklet or pamphlet provided to the subscriber that contains a general explanation of the benefits and related provisions of the dental benefit program. Also known as a Summary Plan Description.
A process where a dentist submits a treatment plan to the payer before treatment begins. The payer reviews the treatment plan and notifies the dentist and patient of one or more of the following: patient’s eligibility, covered services, amounts payable, co-payment and deductibles and plan maximums.