predetermination of benefits
provision
A provision often included in dental policies which
specifies that when dental treatments are expected to exceed a
stated level, such as $100, $150, or $200, the dentist should submit
to the insurer the proposed treatment plan for the patient so that
the insurer can
determine
the amount payable
by the dental plan. Also known as a
preauthorization of benefits provision, precertification
of benefits provision, or pretreatment
review provision.
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