| Topic: Introduction to the Dental Policy Manual
|
Date of Origin: 3/2003 |
| Section: Introduction |
Policy No: Intro 1 |
| Revised/Effective Date: 03/2003 |
Next Review Date: 3/2005 |
Dental Policy
Manual Terms and Conditions
Description
The Regence Group (TRG) Dental Policy Manual contains
Dental Policies approved by TRG.
Dental Policies have been developed through consideration
of government approval status, dental necessity, generally
accepted standards of dental practice, and review of
dental literature.
Use
TRG Plans use Dental Policies as guidelines for coverage
determinations in all health care insurance products,
unless otherwise indicated. TRG Plans include Regence
BlueShield, Regence BlueCross BlueShield of Oregon,
Regence BlueCross BlueShield of Utah, and Regence BlueShield
of Idaho, and any of their affiliated or subsidiary
companies.
Conflict with Plan Documents
In the event of a conflict between a Dental Policy and
any Plan document under which a member is entitled to
Covered Services, the Plan document will govern. Plan
documents include, but are not limited to, Subscriber
Contracts, Summary Plan Documents, and other coverage
documents prepared by a Plan.
Restrictions and Limitations
- Dental Policies DO NOT determine the schedule of
benefits. Rather, Dental Policies are used in the
process to determine if a service will be paid by
a Plan.
- Dental Policies are interpreted and applied in
the sole discretion of the Plan.
- Dental Policy application is subject to state and
federal laws and specific instructions from Plan Sponsors
of self-insured groups.
- Dental Policies DO NOT constitute dental advice
and DO NOT guarantee any results or outcomes. If you
are a member, you should discuss any related dental
health care questions with your dental health care
provider.
- Dental Policies are the property of TRG and you
are strictly prohibited from using them for any commercial
use whatsoever. Commercial use does not include use
of the Dental Policies for purposes related to the
health care of a TRG Plan member. In addition, CDT
codes and descriptions are the property of the American
Dental Association with all rights reserved.
- There is no obligation to update this site and
the Dental Policies displayed may be out of date.
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