Title: Gather information and complete insurance forms as required by the carrier.
Course: Dental Careers II (14054-II) > Section: Performing Administrative Functions

Gathering should include

- information about the beneficiary and subscriber
- use of standard American Dental Association (ADA) procedure codes for treatment rendered by the provider
- signatures of the subscriber and provider
- the carrier's dental coverage plan, including
  - claims appeal process
  - deductibles
  - exclusions
  - limitations
  - maximums
  - preauthorization
  - predetermination of benefits
  - schedule of benefits
  - Unified Carrier Registration (UCR) fees
- provider fee schedule
- submission of completed paper claim forms
- use of the superbill
- electronic submission of claims.

Process/Skill Questions:

- When might a patient be covered under two insurance policies?
- How is an insurance claim submitted?
- What are the different types of dental insurance?
- How does one determine the fee schedule for the office?