DBA — Dental Benefits Associate Patient Practice Questions

A dental benefits associate is reviewing a claim for a patient who received a root canal. What is the purpose of pre-authorization?

• AA. To increase claim rejection
• BB. To limit patient options
• CC. To expedite payment
• DD. To determine medical necessity

When a patient has dual coverage, how should dental benefits be coordinated?

• AA. Only one plan pays no matter what
• BB. Claims should be sent to both simultaneously
• CC. The plan that has been active longest pays first
• DD. The patient decides which plan pays first

During a phone call, a patient inquires about their coverage for orthodontics. What should the associate do first?

• AA. Review the patient's benefit plan
• BB. Suggest orthodontic services without coverage
• CC. Tell the patient they are not covered
• DD. Transfer the call to a manager

In what scenarios would a patient typically experience waiting periods?

• AA. When new dental plans are initiated
• BB. When they are submitting claims
• CC. When they switch dentists
• DD. When they lack dental insurance

A patient is upset about a denied claim for a dental procedure. What is the first step the associate should take?

• AA. Review the claim and reasons for denial
• BB. Explain the policy in detail
• CC. Tell the patient to submit a new claim
• DD. Apologize for the inconvenience