Dental Plan Administrator definition

Dental Plan Administrator means the third party independent of the Employer, who shall determine the amount of benefits payable under all claims submitted to them and who provides claims payment and record keeping as arranged between the Employer and the Dental Plan Administrator
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Examples of Dental Plan Administrator in a sentence

  • Completed grievance forms must be mailed to a contracted Dental Plan Administrator at the address provided below.

  • A contracted Dental Plan Administrator will respond to all requests for pre-certification and prior authorization within 5 business days from receipt of the request.

  • Blue Shield of California and a contracted Dental Plan Administrator reserve the right to review all claims and services to determine if any exclusion or other limitations apply.

  • A con- tracted Dental Plan Administrator will notify you of its determination within 30 days after receipt of the claim.

  • A contracted Dental Plan Administrator will notify the Sub- ▇▇▇▇▇▇▇ of its determination within 30 days from receipt of the claim.

  • The determination of whether the situation required Emergency Services will be made retrospectively by a contracted Dental Plan Administrator based upon an objective review that is consistent with professionally recognized standards of care.

  • A contracted Dental Plan Administrator shall make a decision and notify the Subscriber and Physi- cian within 72 hours following the receipt of the request.

  • Payment or reimbursement of Emergency Ser- vices provided to a Subscriber will be made after a contracted Dental Plan Administrator receives documentation of the charges incurred and upon approval by a contracted Dental Plan Adminis- trator of those charges set forth.

  • Note: A contracted Dental Plan Administrator has established a procedure for our Subscribers to request an expedited decision.

  • A contracted Dental Plan Administrator will notify you of its determination within 30 days after receipt of the claim.