Maximum Plan Allowance definition
Maximum Plan Allowance or “MPA” means the total dollar amount allowed for a specific Benefit.
Maximum Plan Allowance means the amount that a Delta Dental Premier Dentist agrees contractually to accept as full payment for covered procedures. The Maximum Plan Allowance is calculated as a percentile of billed fees.
Maximum Plan Allowance means the lesser of the following:
Examples of Maximum Plan Allowance in a sentence
The Maximum Plan Allowance, or MPA, is the maximum amount that the Plan will reimburse providers.
More Definitions of Maximum Plan Allowance
Maximum Plan Allowance or “MPA” means the amount we will allow for each covered Benefit based on the lowest of:
Maximum Plan Allowance means the total dollar amount allowed under the Contract for a specific Benefit. The Maximum Plan Allowance will be reduced by any Deductible and Coinsurance the Subscriber or Covered Dependent is required to pay.
Maximum Plan Allowance. (or MPA) means the maximum amount Delta Dental will reimburse for a covered procedure. Delta Dental establishes the MPA for each procedure through a review of proprietary filed fee data and actual submitted claims. MPAs are set annually to reflect charges based on actual submitted claims from providers in the same geographical area with similar professional standing. The MPA may vary by the type of network Dentist.
Maximum Plan Allowance or “UCR” means the amount determined by the applicable Delta Dental Plan as the highest amount allowed for a particular procedure, service, or item for the particular Dentist or service provider. The amount allowed for a particular Dentist or service provider depends on its, his or her participation status (e.g., PPO Dentist, Premier Dentist or Non-Participating Dentist).
Maximum Plan Allowance means the most that a Provider is allowed to charge for a procedure. Delta Dental reviews the limits twice a year. Delta Dental reserves the right to increase or decrease fees for any procedure in its sole and absolute discretion.
Maximum Plan Allowance means the lesser of the following:
a. In the case of a Participating Delta Dental Premier Dentist: