Predetermination of benefits provision

In dental policies, a clause specifying that when dental care is expected to exceed a certain level, the dentist must submit a proposed treatment plan to the insurance company so that a determination can be made of how much the dental plan will pay. Also called preauthorization of benefits provision, precertification of benefits provision, or pretreatment review provision.

Leave a Reply

Your email address will not be published. Required fields are marked *