DIAGNOSTIC & PREVENTIVE SERVICES Clause Samples

The "Diagnostic & Preventive Services" clause defines the scope of dental or medical services that are focused on identifying health issues early and preventing future problems. Typically, this clause outlines which routine exams, cleanings, screenings, and preventive treatments are covered under an insurance plan or service agreement, often specifying frequency limits or eligibility criteria. Its core function is to ensure that individuals have access to essential preventive care, thereby reducing the likelihood of more serious and costly health issues developing later.
DIAGNOSTIC & PREVENTIVE SERVICES. 3.1.1 Oral Evaluations
View SourceView Similar (9)
DIAGNOSTIC & PREVENTIVE SERVICES. 100% (Deductible does not apply). Those dental ser- vices identified in the American Dental Association's Code on Dental Procedures and Nomenclature as Code #00100-00999, including: (a) initial, periodic or emergency clini- cal oral examinations; (b) Most dental radiographs including full mouth series, bitewing radiographs, and periapical radiographs; (c) Tests and laboratory examinations; (d) Dental prophylaxis (cleaning); (e) Topical application of fluoride; (f) Space maintenance therapy in primary and/or transitional (or mixed) dentition.
View SourceView Similar (2)
DIAGNOSTIC & PREVENTIVE SERVICES. 3.1.1 Oral Evaluations (Examinations) 3.1.2 X-rays
View SourceView Similar (2)
DIAGNOSTIC & PREVENTIVE SERVICES. Payable at 100% of usual, customary and reasonable charges at participating dentists: Initial oral exams - 1/36 months Periodic Oral exams – 2/Year Prophylaxis – 2/Year Topical application of fluoride - 2/Year to age 19 Space maintainers to age 19 X-rays Emergency Treatment
View SourceView Similar (2)
DIAGNOSTIC & PREVENTIVE SERVICES. 100% (Deductible does not apply). Those dental services identified in the American Dental Association's Code on Dental Procedures and Nomenclature as Code #00100-00999, including: (a) initial, periodic or emergency clinical oral examinations; (b) Most dental radiographs including full mouth series, bitewing radiographs, and periapical radiographs; (c) Tests and laboratory examinations; (d) Dental prophylaxis (cleaning); (e) Topical application of fluoride; (f) Space maintenance therapy in primary and/or transitional (or mixed) dentition.
View Source
DIAGNOSTIC & PREVENTIVE SERVICES. 3.1.1 Oral Evaluations We cover one (1) periodic oral evaluation or one (1) emergency oral evaluation per
View Source

Related to DIAGNOSTIC & PREVENTIVE SERVICES

  • Preventive Services All necessary procedures to prevent the occurrence of oral disease, including: Cleaning and scaling Topical application of fluoride Space maintainers

  • Outpatient Dental Anesthesia Services This plan covers anesthesia services received in connection with a dental service when provided in a hospital or freestanding ambulatory surgical center and: • the use of this is medically necessary; and • the setting in which the service is received is determined to be appropriate. This plan also covers facility fees associated with these services. This plan covers dental care for members until the last day of the month in which they turn nineteen (19). This plan covers services only if they meet all of the following requirements: • listed as a covered dental care service in this section. The fact that a provider has prescribed or recommended a service, or that it is the only available treatment for an illness or injury does not mean it is a covered dental care service under this plan. • dentally necessary, consistent with our dental policies and related guidelines at the time the services are provided. • not listed in Exclusions section. • received while a member is enrolled in the plan. • consistent with applicable state or federal law. • services are provided by a network provider.

  • Diagnostic procedures to aid the Provider in determining required dental treatment.

  • Mastectomy Services Inpatient

  • Telemedicine Services This plan covers clinically appropriate telemedicine services when the service is provided via remote access through an on-line service or other interactive audio and video telecommunications system in accordance with R.I. General Law § 27-81-1. Clinically appropriate telemedicine services may be obtained from a network provider, and from our designated telemedicine service provider. When you seek telemedicine services from our designated telemedicine service provider, the amount you pay is listed in the Summary of Medical Benefits. When you receive a covered healthcare service from a network provider via remote access, the amount you pay depends on the covered healthcare service you receive, as indicated in the Summary of Medical Benefits. For information about telemedicine services, our designated telemedicine service provider, and how to access telemedicine services, please visit our website or contact our Customer Service Department.