CDC Dental Management 3

Question 1

Which document governs the terms under which a dental practice participates in an insurance network?

Accepted Answer

Provider participation agreement

Answer

A provider participation agreement outlines the contractual terms, fee schedules, and obligations between the dentist and the insurance carrier.

Question 2

When a patient has dual dental insurance coverage, which policy typically pays first?

Accepted Answer

The primary policy, determined by the birthday rule or employment status

Answer

Coordination of benefits rules—often using the birthday rule for dependents or employment status for adults—determine which plan is primary and pays first.

Question 3

A dental practice receives a lower-than-expected reimbursement from an insurer. The most appropriate first step is to:

Accepted Answer

Request a detailed explanation of benefits and compare it to the submitted claim

Answer

Reviewing the EOB against the submitted claim helps identify whether the underpayment stems from a coding error, fee schedule discrepancy, or insurer mistake.

Question 4

Which management approach focuses on scheduling high-value procedures early in the day to protect production goals?

Accepted Answer

Block scheduling

Answer

Block scheduling reserves specific time slots for high-production procedures, ensuring revenue-generating appointments are protected from lower-priority bookings.

Question 5

Under HIPAA, a dental practice's Notice of Privacy Practices must be provided to patients:

Accepted Answer

At the time of first service delivery or upon request

Answer

HIPAA requires covered entities to provide the Notice of Privacy Practices no later than the date of first service delivery and to make it available upon request.

(CDC) Certified Dental Consultant Practice Test

(CDC) Certified Dental Consultant Practice Test

CDC Dental Management 3