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QLM Life & Medical Insurance Company Q. P. S. C We bring to you innovative and tailor-made insurance solutions coupled with a world-class level of service. www. qlm. com. qa Dental Guidelines | Dental Guidelines 1 2.pdf |
Dental Guidelines Select the correct category (Dental Category) and tooth number (for applicable services) to prevent unnecessary denials. Services evaluation andapproval based onthe Core privileges (for General Dentist) &Non-core privileges (forcertified specialists) only asper QCHP guidelines. Services validation and... | Dental Guidelines 1 2.pdf |
Dental Guidelines Myofunctional Appliances coverable only Ifthepolicy mentions orthodontic treatment covered irrespective Iiof age or interceptive orthodontic treatment covered. Transparent & ceramic brackets and Invisalign or clear Aligners are not covered unless mentioned in the TOB of the policy. Cosmetic and Congen... | Dental Guidelines 1 2.pdf |
Dental Guidelines Bone grafts andflap surgeries must accompany a detailed dental report,pre-service x-ray, periodontal chart, andoperative notes. Surgical and complicated extraction must accompany adetailed operative note and pre-service x ray. Orthodontics claims require Cephalogram, OPG, photos, Orthodontic assessmen... | Dental Guidelines 1 2.pdf |
Service Description Pre-Service Post-Service Accepted Radiology Method Root Canal Treatment Yes Yes IOPA Complicated Extraction/Surgical extraction/Impacted /Embedded molars /Cysts of jaw Yes No IOPA or OPG Multiple restorations above 3 At a time, Interproximal caries, large carious lesions. No Yes OPG or IOPA Implants... | Dental Guidelines 1 2.pdf |
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