Participating Dentist Clause Samples

Participating Dentist. A Dentist who has entered into an agreement with the Plan to bill the Plan directly for Covered Services, and to accept the Plan’s allowance as payment. Participating Dentists include the following: • A Dentist who has entered into a Participating Provider Agreement with the Plan; • A Dentist who has contracted directly with any division or subsidiary of Health Care Service Corporation (HCSC); • A Dentist who is a member of any other network with which Health Care Service Corporation or any of its subsidiaries has contracted. A person who is a professional practitioner of a Healing Art defined and recognized by law, and who holds a Physician license duly issued by the state or territory of the United States in which the person is authorized to practice medicine or surgery or other procedures and provide services within the scope of such license.

Participating Dentist a Dentist who has signed a Delta Dental Participating Agreement. A Dentist who has signed a Participating Agreement with a Delta Dental company in another state is also considered a Participating Dentist.

Participating Dentist. A Dentist who has signed a Participating Agreement with Delta Dental Plan of Maine or any other Delta Dental company. A Participating Dentist is required to submit appropriate clinical documentation for procedures. All clinical procedures are subject to review of clinical notes, radiographs, etc. to determine coverage.

Participating Dentist a Dentist who has signed a participating agreement with Northeast Delta Dental or another Delta Dental company. A Participating Dentist agrees to abide by such uniform rules and regulations as are from time to time prescribed by Northeast Delta Dental.

Participating Dentist. A Dentist who has signed a Participating Agreement with Delta Dental Plan of Maine or any other Delta Dental company.

Participating Dentist. These are dentists who have a signed agreement currently in effect with FCL or a third party contracted by FCL to provide dental benefits through their network to participate in our dental plan. Participating dentists have agreed to accept the lesser of the actual charge or the FCL allowance or the allowance established by a third party contracted by FCL to provide dental benefits through their network as payment in full for covered services. The insured is not responsible for charges in excess of the allowance. The insured is responsible for the deductible, coinsurance, and the payment of charges for non-covered services and charges in excess of any maximum benefit limitations. The participating dentist will file the claim on the insured’s behalf and payment will be made directly to the participating dentist. A list of participating dentists will be made available to you. This list is subject to change without prior notice to, or approval of, the contractholder or certificateholder.

Participating Dentist. On the date of service, if the dentist is a participating dentist (a dentist who has signed an agreement with Delta Dental):