List of VARIABLES:
Norminal:genotype of names ex:gender
Terms used in Dental Insurance Billing
Some of the most commonly used cost containment measures are:
Least Expensive Alternative:
Treatment Provision (LEAT) A dental plan may not allow benefits for all treatment options. A Least Expensive Alternative Treatment Provision is a limitation found in many plans which reduces benefits to the least expensive of other possible treatment options as determined by the benefit plan, even when the dentist determines that a particular treatment is in your best interest. For example, the dentist may recommend a fixed bridge, but the plan may allow reimbursement only for a removable partial denture. The patient may not always understand the payer’s least expensive treatment policy, and what the out of pocket costs are, until the explanation of benefits (EOB) is received.
The health insurance definition of out-of-pocket costs is any amount of money that will have to come from you, hence the term “out of [your]pocket”. Two main areas to understand out-of-pocket costs in
insurance are the out-of-pocket costs for services not covered and the out-of-pocket costs you are expected to pay before your insurance will pay.
Out-of-pocket costs include expenses that your insurance company does not feel are covered services included in your plan. Some examples would be elective procedures, such as cosmetic surgery or procedures specifically excluded by your insurance company. If you don’t want to have to pay for something out-of-pocket, you can easily find out what services are not covered by your insurance company by calling them and asking.
Another main out-of-pocket cost in health insurance are the costs you are expected to pay for covered procedures before your insurance will pay. The two primary ones are your deductible and co-insurance.
The deductible is the amount you have to pay, out-of-pocket, before your insurance company will start paying.The co-insurance amount is the percent you are required to pay towards a covered procedure. For example, your insurance company may cover 80% of your surgery and you have to pay the remaining 20% out-of-pocket. There is usually an out-of-pocket maximum and once that is reached the insuran
ce company will cover 100% of the costs and the deductible and co-insurance payments count towards the out of pocket maximum.
Most health insurance policies have a coinsurance, or sometimes misspelled as co insurance, clause. This simply is the percentage amount you are required to pay towards your health insurance bill when
you file a health insurance claim. The coinsurance percentage is usually in addition to the deductible, that would need to be paid first before the insurance company would pay anything.
Mary Jo had a 20% coinsurance clause on her new health insurance policy. She just got a bill, for her recent surgery, from her health insurance company. The total of the bill was $2000. Her health insurce
deductible was $200 for the year and none of her deductible was paid yet since this was her first claim. This means that Mary Jo would need to pay, out of her own pocket, her full deductible ($200), and then 20% of the remaining amount of the insurance bill ($360). So, her total out of pocket expense for her surgery was $560 ($200+$360).
The copayment is a fixed amount the insured is required to pay to the provider. Some call it the co-payment or copays since there can be different copayment amounts for different services.
Copays are usually what one pays when they visit a doctor or purchase a prescription. The copayment is almost always required at the time of service or at the time one would purchase their prescription medication. Then the doctor or pharmacist will bill the insured’s insurance company for the remaining amount due.
Sometimes copays are confused with the co-insurance payment. The co-insurance payment is different as it is a percentage that the insured is required to pay and is usually due for larger procedures such
as a surgery.
Examples: Dean needed to go see his doctor for a lingering cough. When he went to his visit, he was 1required to pay a $40 copayment to the doctor at the time of service. The doctor’s office then billed the remaining amount due to Dean’s insurance company.
Downcoding is a practice of third-party payers in which the benefits code has been changed to a less complex and/or lower cost procedure than was reported except where delineated in contract agreements.
Predetermination of benefits is an administrative procedure that may require the dentist to submit a treatment plan to the third party before treatment begins. The third party usually returns the treatment plan indicating one or more of the following: patient’s eligibility, covered services, benefit amounts payable, application of appropriate deductibles, co-payment and/or maximum limitation. Under some programs, predetermination by the third party is required when covered charges are expected to exceed a certain amount.
Claims bundling is the systematic combining of distinct dental procedures by third-party
payers that results in a reduced benefit for the patient/beneficiary. The ADA considers bundling of procedures to be potentially fraudulent.
Bundling: What is often described as bundling is the effort of payers to follow guidelines established in the Code. For example, payers commonly see claims submitted with the following combinations of services that are not consistent with the Code:
Pins reported as a separate service from a core buildup (the D2950 buildup code includes pins);
Adhesives, bases or liners as a separate service from the restorations (the Code defines these to be included as part of the restoration);
Occlusal adjustments and minor adjustments to prostheses as a separate service, when the prosthetic service includes routine post-delivery care;
Suture removal, as a separate service from the extractions, which include suturing and postoperative q; and
X-rays taken during the course of root canal therapy as a separate service from the root canal, which by definition, includes intra-operative X-rays. For the examples above, payers will often
consider these component services as part of the main procedure inaccordance with the Code and pay benefits accordingly.
Positive reinforcement occurs when an event or stimulus is presented as a consequence of a behavior and the behavior increases. Example: A father gives candy to his daughter when she picks up her toys. If the frequency of picking up the toys increases, the candy is a positive reinforcer (to reinforce the behavior of cleaning up).
Negative reinforcement occurs when the rate of a behavior increases because an aversive event or stimulus is removed or prevented from happening. Example: A person puts ointment on a bug bite to soothe an itch. If the ointment works, the person will likely increase the usage of the ointment because it resulted in removing the itch, which is the negative reinforcer.
Positive punishment occurs when a response produces a stimulus and that responses decreases in probability in the future in similar circumstances. Example: A mother yells at a child when he or she runs into the street. If the child stops running into the street, the yelling acts as positive punishment because the mother presents (adds) an unpleasant stimulus in the form of yelling.
Negative punishment occurs when a response produces the removal of a stimulus and that response decreases in probability in the future in similar circumstances. Example: A teenager comes home after curfew and the parents take away a privilege, such as cell phone usage. If the frequency of the child coming home late decreases, the removal of the phone is negative punishment because the parents are taking away a pleasant stimulus (the phone) and motivating the child to return home earlier.
Pleasant Stimulus Aversive (unpleasant) Stimulus
Adding/Presenting Positive Reinforcement Positive Punishment
Removing/Taking Away Negative Punishment Negative Reinforcement
5 year survival rate
90% in lip cancer
50% in oro pharyngeal cancer
45% in tongue cancer
20% in africal American oro pharyngeal cancer whose oral hygiene is badp
Biostatistics in Pt management
* Validity….> should be compared to gold standard and should be high sensitive,B and unbiased
*Realibility….> should be reproducible and repeatable with same value means produce similar results
* Sensitivity….> % of persons having the disease TP/TP+FN X 100%
* Specificity ….> % of persons not having the disease TN/TN+FP X 100%
* predictive value positive….> TP/TP+FP X 100%
* predictive value negative….> TN/TN+FN X 100%
Highest prevalence of caries = Hispanics
Highest DMFT = White (caucasian) (highest amount of restored teeth)
Highest untreated primary teeth = Hispanic
Highest untreated perm teeth = Black (African American)
Moderate periodontitis = Black males ( African American)
Class II caries = Whites (caucasian)
Class III caries = Blacks (African American)
Cleft lip/palate w/ Class III occlusion = Native American
Cleft lip alone = Asian
Cleft lip in USA = 1:700 to 1:800
class 2 malocclusion : whites of northern European descent
class 3 malocclusion : Asian
Caucasians have more lip cancer while African american have more oropharyngeal carcinoma.
Anterior open bite: African American(blacks)
Deep bite: cuacasian( whites)
Cemento osseous dysplasia – black middle aged women
LEGEND of materials and equipment safety in PT management
*Air born particlesp1) Spatter….>large visible particles 50um or larger and its the route of infection of blood borne pathogens
2) MIST….> settle from air after 10-15 mins and is produced by cough
3) Aerosol….>invisible particles between 5-50um floating in air for hours
* Current OSHA standard for mercury is 0.1mg /m3 over an 8 hours work shift
*Noise inducing hearing loss….> above 90db and protection recommended when noise reaches 85db (Autism pts are very sensitive to loud sounds,,,,put muffler on ur turbine and work!!!!!!!)
* during photopolymerization of composite or any resin material (bridge to operative….> 1-1.5mm from restoration and use of VLC and alpha diketone with camphor quinone to initiate the polymerization) always wear eye protector to avoid retinal damage
*before starting any clinic flush all dental instruments including handpiece for several mins to ensure that the waterline is < 500CFU/mL.
*MSDS is regulated by manufacturers for employees and use colors to notify the employees as follows:
1) blue….> health hazard
2) red….>fire hazard
3) yellow….>reactivity and stability of chemicals
4)white….> use PPE
LEGEND of Organization in Pt. management
* ACF….> associated with economy and social well being ex.low income children get free food meal in school
*CMS….> medicaid and medicare
*Medicare….> for elderly and disabled people
*Medicaid…..> for low income people elderly and children
*EPSDT program….> dental services for children
*CHIP program….> offers basic preventive and diagnostic services ex.vaccinations
*HRSA….> offers health care services for uninsured live in rural areas and urban neighborhoods plus dental services for HIV pts
*CDC….> prevent outbreak of disease and dental infection control ex.community water fluoridation
*FDA….>protecting health against impure and unsafe foods plus temp. of autoclave
*NIH….> deals with supporting medical researches
*NIDCR….> branch of NIH deals with dental researches
*AHRQ….>support health care system and quality
*HHSA…..> provides a broad range of health and social services, promoting wellness, self-sufficiency, and a better quality of life for all individuals and families
*DEA….>combatin g drug smuggling and deals and also has sole responsibility for coordinating and pursuing U.S. drug investigations abroad.
J*NHANES…..>a program of studies designed to assess the health and nutritional status .
Q. Through the bloodborne pathogen standard, the occupational safety and health administration directs activity for each of the following except one. Which one is the exception?
a. Using barrier techniquesgg,
b. Using material safety data sheets
c. Obtaining hepatitis B vaccines
d. Communicating hazards to employees
e. Performing housekeeping Ans.B
(material safety data sheets are now called safety data sheets. I was asked this in the exam.)
Q. Stress and illness are often related. The best description of their relationship is which of the following?
a. Stress is primary cause of illness
b. Illness is adaptation to stress
c. Stress is a psychological reaction
d. They often occur together but are casually unrelated
e. Stress is contributory to illness and illness is usually stressful Ans.E
Q. On the basis of diagnostic test results, a dentist classifies a group of patients as being free from disease. These results possess high
d. Repeatability Ans.B
Q. In pursuit of what the dentist believes is best for the patient, the dentist attempts to control patient behavior. This is known as
d. Paternalism Ans.D
Q. Most epidemiologic studies indicate that gingivitis in children is relatively common. A strong positiv association between specific nutritional deficiencies and the presence of periodontal disease in children and adults has been demonstrated.
1. both r true
2. both r false
3. 1st true, 2nd false
4. 1st false , 2nd true Ans.3
Q. In assessing patient’s dental fears, the dentist should use each of the following factors except one. Which one is the exception?
a. Verbal statements
b. Physiological responses
d. Personality Ans.D
Q. HIPAA was designed to
A) ensure the security and privacy of health information
B) provide insurance coverage for providers
C) increase hospital testing ability
D) encourage employees to stay in their jobs to retain insurance coverage Ans.A
Q. information about subjects in a study included their ethnicity. what level of measurement is ethnicity?
4. Interval Ans.B
Q. MOST APPROPRIATE TEST TO DETERMINE THE DIFFERENCES BETWEEN TWO MEANS?(Answer giving examples on BOTH)
CHI SQUARE TEST
T TEST Ans.B
Q. What’s the prophylactic regimen for patients with prosthetic joints.
Ans. Antibiotic prophylaxis guidelines also have been developed for people who have orthopedic implants such as artificial joints. In 2012, the ADA and American Association of Orthopedic Surgeons updated the recommendations and no longer recommend antibiotics for everyone with artificial joints. As a result, your healthcare provider may rely more on your personal medical history to determine when antibiotics are appropriate for people with orthopedic implants. For example, antibiotic prophylaxis might be useful for patients who also have compromised immune systems (due to, for instance, diabetes, rheumatoid arthritis, cancer, chemotherapy, and chronic steroid use), which increases the risk of orthopedic implant infection.
Q. A patient after extraction says”Thank you,that wasent as bad as i expected,but my sister told me that the first night after having a tooth pulled is very painful.What if the medication u gave me isnt strong enough!?Choose the most appropriate answer.
1)Did she make you feel worried about that?
2)It sounds like you are worried that you might not have enough pain relief when ur home.
3)I understand your concern
4)Dont worry i’ll give you plenty of pain medication
5)it sounds like your sister had a unusually bad experiance.Dont let other worry you,you’ll be just fine. Ans.B
Q. The most important concept of C.E.A. Winslow’s definition of public health is:
To encourage mental and physical efficiency
Promotion through organized community effort
Individuals acting alone can solve any problem
The science and art of preventing disease Ans.B
( C.E.A. Winslow, characterized public health practice as the science and art of DISEASE PREVENTION, prolonging life, and promoting health and well-being THROUGH organized community effort..So Answer is D!)
Q. A moderately mentally challenged 5-year-old child becomes physically combative. The parents are unable to calm the child. Which action should the dentist take?
Force the nitrous oxide nosepiece over the child’s mouth and nose.
Hand over mouth exercise (HOME).
Discuss the situation with the parents.
Firm voice control. Ans.C
Q. Which of the following is the principal nonverbal cue that two or more people can use to regulate verbal communication?
facial expressions Ans.A
Q. In an experiment comparing the effectiveness of new flouride gel verses an older flouride gel, a null hypothesis is rejected when
1) a chi square is zero
2) a chi square is high
3) a chi square is low
4) the experimental and control groups have similar results Ans.B
( If you have higher chi-square, there is a high likely chance of your p-value being less than 0.05, so in that case you reject your null hypothesis.)
Q. On a prepayment basis, dental patients receive care at specified facilities from a limited number of dentists. This practice plan is classified as which of the following?
Solo practice Ans.1
Q. can some one please explain deductible , copayment, coordination of benefits, co insurance??
Ans. A co-payment, is a flat fee that the patient pays at the time of service. The fee is usually small, such as $10 or $15.
Co-payments are common in capitation plans (e.g. DHMO), and less common in Preferred Provider Organization
A deductible is a flat amount that the employee must pay before they are eligible for certain benefits. The deductible may be an annual or a one-time charge.
co insurance -patients must pay a portion of the services they receive
Q. Which of the following computer databases contain references to dental literature electronically ?
4)Index to dental Literature Ans.B
Q. The measure of the quality of care provided in a particular setting is called:
Quality inspection Ans.3
( and the steps taken to improve deficiencies is quality assurance)
Q. Which of the following is a social enforcer for a child?
a. Dentist provides toothbrush kit
b. Allows child to watch his favorite tv show
c. Provide the child with stickers of his best cartoons
d. Pat on the back of the child’s shoulder Ans.D
Q. Which is not a part of classical conditioning:
6. Spontaneous recovery Ans.2
Q. The following were the scores for six dental students in their restorative dentistry exam :
56, 64, 68,46, 82,86.
Therefore the median is_____________
( whnever thr is even number of figures like here 6 figures are. always take 2 middle, add these 2, and thn divide it by 2… if the given set of nos are even then you have to add the two middle numbers and divide by 2. If the given set is odd then just pick the middle one. have to order data in an ascending way first, so that will be 46, 56,64,68,82,86,)
Q. Which of the following may be used to disinfect gutta percha points?
4)Dry heat Ans.3
Q. Correlation analysis shows that as the income of population increases, the number of decayed teeth decreases. Therefore, an expected value for this correlation coefficient (r) would be -1, Ans.YES
Q. Which federal agency protects the health of Americans and provides essential human services?
None of the above Ans.DHHS
Q. Which is the most important feature of systematic desensitization?
Q. Which statement is incorrect about behavior change?
a.Shaping is a behavior change strategy in which the patient learns though demonstration.
b.The behavioral model consists of antecedents, behaviors, and consequences.
c.Goals are long-term targets, whereas objectives are reachable steps along the way.
d.Positive consequences will strengthen a behavior and negative consequences will weaken it.
e.Consequences of today’s behavior will affect behavior tomorrow. Ans.A
Q. network model is often used in
3. D-PPO Ans.1
( it follows the fee for service plan)
Q. If a dentist is stuck with a needle while treating an HIV-infected patient, which should he perform?
a.Stop work and apply hypochlorite 1:10 to the finger for 5 minutes
b.Stop work, compress the affected area, and apply hypochlorite
d.Stop work, compress the affected area, and wash with soap and water Ans.C
( its given as C , compressing or squeezing the affected area is not recommended)
Q. The substitution of a relaxation response for an anxiety response using a relaxation strategy such as diaphragmatic breathing when one is exposed to a feared stimuli is called?
1)Progressive muscle stimulation
(Yup 4 its.. flooding is just a branch from desensitization which works on treating patient by repeating the fearful response till he gets used to it.)
Q. When a patient expresses anger about a physician’s colleague,
which of the following statements would be the most appropriate
a. Why are you so aggravated over something so trivial?
b. Before I ask any questions, please calm down.
c. What concerns do you have about how you were treated?
d. Why don’t we go talk to Dr. X about your anger? Ans.C????
Q. A patient has difficulty inhibiting the gag reflex during x-ray procedures. The patient is asked to take an x-ray packets home and practice holding the packet in his mouth for increasingly longer periods. Which technique is being used?
Systematic desensitization Ans.A
Q. Which is not correct about stress?
a. Predictability-less predictability causes more stress.
b. Controllability – less controllability causes the more stress.
c. Familiarity-less familiarity causes more stress.
d. Positive situations are less stressful than negative situations.
e. Imminence-more imminent situations are more stressful. Ans.D
Q. The following component of a scientific article provides the reader with detailed information regarding the study design:
C. Literature review
E. Abstract Ans.D
Q. incidence of untreated coronal caries is higher in
causcasians or african american or identical for both Ans.African
(Adult untreated caries— African Anerican
Pediatric untreated caries— Hispanics)
Q. A patient says that, “Even if there is some pain, it will be brief. I have effective methods of coping.” The patient reminds himself of this during dental procedures. This patient’s statement exemplifies which strategy?
Systematic desensitization Ans.C
Q. Ryan white care act provides dental care to HIV + / AIDS individual. They get their funds via
4. NIDCR Ans.3
Q. A student performs a complicated symphony, and he becomes less anxious each time he performs. Which phenomenon is this?
Q. 5 year survival rate of oropharyngeal cancer is
4-75% ans.2 ( lip.CA…> 90% Tongue CA…..>45%)
Q. OSHA standard for mercury is
1. 1mg per cubic meter for 8 hr work shift
2. 0.1 mg cubic meter for 4 hrt work shift
3. 0.5 mg cubic meter for 8 hr work shift
4. 0.05 mg cubic meter for 4 hr work shift Ans.4
(well right value is 0.1 mg percubic meter in 8 hrs of working … but not in options so next appropriate will be option 4 )
Q. Percentage of USA with Community water fluoridation
c. 80% Ans.B ( 65-70%…67% is average but nearest option given is 60%)
Q. Prevalance of subgingival calculus in US ADULTS as suggested by surveys is
Q. percentage of DFS is more in – cacucasians , hispanics , blacks, asians???
Ans. causacians…(WHite people are more conscious to dental treament and get more caries…the more caris they get the more filled it will be…so prevalence and filled surfaces are high in whits or causacians…Black people are mostly poor and couldnt afford dental services. So they have high chances of Untreated caries..)
Q. outliers control
standard deviation Ans.D
(an outlier is an observation point that is distant from other observations. An outlier may be due to variability in the measurement or it may indicate experimental error; the latter are sometimes excluded from the data set.)
Q. incidence of coronal caries is higher in
causcasian or african american or identical for both Ans.A
Q. Contaminate sharps must be handled in such ways except for
a.The container must be labeled
b.The container has a metal case
c.The container has to be non puncturable
d.The container must be closable. Ans.B (yellow plastic disposable can with lid)
Q. Which is the acceptable CDC water quality in a dental office
<1000 CFU/mL Ans.B
Q. Which is the best qSuestion to ask a slightly nervous child?
1.Are you worried about pain?
2.Are you nervous? 3.”Why can’t you be quiet?”
4.”Can you tell me what is bothering you?” Are you worried about the needle?” Ans.4
Q. Test result which erroneously assigns an individual to a specific diagnostic or reference group, due particularly to insufficiently exact methods of testing is known as:
A false negative test
A true negative test
A false positive test
A true positive test Ans.3
Q. Gi index – ordinal , right? Ans.YES
Q. Which term listed below measures the proportion of those without disease who
are correctly identified by a negative test:
Q. A 38-year-old man is fearful of injections. First, you show him the syringe. You talk about the characteristics of the needle. You then place the needle in his mouth with the cap on and simulate the procedure with the cap on. You then simulate the procedure with the cap off. Eventually, you proceed with the injection. What method is being used to reduce fever
5.Behavior modification Ans.2
(the thing we can change by changing other factors is dependent variable, u see which can be changed out of of 4 options by self instruction and lectures? this is only D)
Q. if there is an article and if you want to underatand the definition of
Dependent and independent, which part of the article you look:
(its introduction or background in which u describe ur hypothesis definitions of dependant and independant variables, innovations, specific aims… define variables in introduction, methods of variable recording is in method section)
Q. Researches showed to remove plaque from the resident’s teeth more effectively with mechanical toothbrushes than with manual ones. What is the independent variable in this study?
1) The gingival health of the residents
2) The amount of plaque present on the resident’s teeth
3) The type of toothbrush used
4) Time of day that brushing took place
5) How long teeth were brushed Ans.3
(Independent variable can be changed so tooth brushes design could be changed… 3, independent variables, 2 is dependent variable)
(those who donot smoke and having lung cancer is C, those dont smoke and haelthy is D. sum these to get total non smokers, (healthy and cancered) thn devide cancered non smoker(c) with total(c+d), u will get ratio of lung cacer in non smokers. if u multiply it by 100, u will get percentage of lung cacer in non smokers.)
Q. 70 percent dentists become anxious with anxious dental patients.
Q. Obtaining informed consent hold true in each of the following cases except:
1. A conscious mentally competent patient.
2. A pregnant patient
3. In emergency cases
4. None of the above Ans.3
(In cases of emergency if the pt. Or legally responsible party is not able to give consent, doctor may proceed without it.
Q. do you any idea about minors, under 18, in this regard?Ans. Under 18 can give implied consent but not actual consent… But under 18 can give consent to their treatment if : they are living independently, are pregnant, married and an emancipated minor can give consent for his/her child.
Q. Providing and explaining the informed consent to the patient in understandable terms is considered a duty of:
1. The office receptionistu
2. Dental assistant
4. Attending dentist Ans.4
( he has modified his behaviour by thinking positive
Q. In the section of a scientific aritcle,the researcher interprets and explains the results obtained in?
2)summary and conclusion
5)none of the above Ans.3
Q. HOME is an example of:
1. Positive reinforcement
2. Negative reinforcement
3. Positive punishment
4. Negative punishment ans.3
(you add something to decrease the behavior so it should be positive punishment,….. in negative punishment, you decrease something to eliminate undesired behavior)
Q. Restoring a carious tooth relieved the toothache in a patient which further motivated him to perform better oral health care. This is a type of
1. Positive reinforcement
2. Negative reinforcement
3. Positive punishment
4. Negative punishment Ans.B
Q. One of your patient is having a dental problem that is not under your capability and you are referring that patient to a specialist,this type of behavior comes under which of the following codes?
Q. what do we watch in a patient during dental treatment to find out if he’s in pain??
5) eye brows
5) none of the above Ans.4
Q. Women have a lower survival rate of cancer of the lip..T/F? Ans.T
( Women have higher survival rate then men for oral cancers with exception cancer of the lip..So its rue)
Q. Dental waterline should be flushed at beginning of day for
3.60 sec Ans.A (30 according decks 60 according mosby)
Q. 1 L of 1 ppm of NaF contains how many G flouride? Ans.0.5
Q. Statute of limitations- can someone please explain?
Ans. Minimum 2 years of time from Malfunction incident by dentist to patient’s sue procedure….. time starts when dentists inform the patient about the incident.)
Q. incidence of cleft lip and palate, 1:1000 and 1:2000, right? Ans.Yes
(1:700 n 1:800 in US)
Q. what is the difference between flooding and systemic desensitlization?
Ans. Systemic desensitization uses a hierarchy of slowly increasing the anxiety provoking stimuli like from least anxiety provoking to most allowing the pt to use his coping skills.
In flooding there is a intense prolonged exposure to a feared stimulus at a time wherein the pt uses coping skills to deal with the exposure.
In simple language systemic desensitization is step by step increase stimulus
And In flooding, it is everything at a single step
Q. What is bundling, unbundling, upcoding, down coding
Ans. upcoding – if you treat tooth with one crown and you get the money for two crown this is upcoding,
downcoding is the reverse of upcodid, you treated two tooth, fixed two crowns but you get the money for one only.
Bundling is when a dentist submits a claim for two or more procedures performed on a single pt. During office visit and the ensurer bundles the services together and only pays for one service.
Unbundling is the practice abused by dentist to get a program to pay more than the actual benefits by charging a separate fee for each component. Eg if the service for a crown was unbundled the dentist would send separate fees for temp. Crown, tissue prep, occlusal correction etc instead of charging one fee for the crown.
Q. While extracting a maxillary molar, you lose a root down the maxillary sinus which cannot be retracted at the moment. You do not inform the patient of the incident. Which code of ethical principle did you break?
2. Non malifecence
3. Patient Autonomy
5. Justice Ans.4
Q. Which will aid in the cognitive appraisal of a threat?
1.Adaptability, preventability, inevitability, and constancy
2.Controllability, familiarity, predictability, and imminence
3.Interference, adaptability, longevity, and reactance
4.Validity, reliability, adaptability, and predictability
5.Accountability, reliability, validity, and familiarity Ans.2
Q. Can you please clarify that confusion between HMO, PPO,?
HMO — Health Maintenance Organization. You have one primary care physician through whom all your health care services go. If you need to see a specialist you have to first see your primary health care provider, who if can’t help you will provide you with a referral. Also the visits to doctors outside your network won’t be covered by insurance.
PPO- preferred provider organization
You don’t need a primary care physician . You can go to any health care provider you want without a referral – outside or inside your network
Hmo: Dentist getts fixed monthly amount for each patient or family. They gets paid irespective of the no. of treatment provided whether they provide treatment more than the fee they get from insurance or they provide less valuable treatment as compared to their fix amount which they get from insurance monthly… dentist will get fixed amount anyway
Q. Which of the following are necessary for a test to be accurate?
Q. when patient have to pay from his pocket??
third party payment Ans. A and B
Q. A dentist is doing research on 5 unrelated patient with different background. He record data ……etc.dentist is doing what kind of research?
a. clinical trial
c. sectional Ans.Cross sectional
Q. how does parent of special needs child feel most of the time?
Q. which of the following MOST accurately explains how biofeedback works
a. it reduced cognitive dissonance
b. it stimulates the sympathetic nervous system
c. it relax and to some extent hypnotizes the patient
d. it distracts and engages the patient in an active coping task.
e. it enables the patient to gain control of certain physiological function Ans.e
(Biofeedback therapy involves training patients to control physiological processes such as muscle tension, blood pressure, or heart rate.
These processes usually occur involuntarily, however, patients who receive help from a biofeedback therapist can learn how to completely manipulate them at will.
Biofeedback is typically used to treat chronic pain, urinary incontinence, high blood pressure, tension headache, and migraine headache. )
Q. According to ADA publication entitled principles of ethics and code of professional conduct, a dentist can announce specialization in which of the following?
b. hospital dentistry
c. aesthetic dentistry
d. dental public health
e. geriatric dentistry Ans.D
Q. What does the Weight and height stand for in recordings?
* Nominal Ans. Ratio scale
Q. where you can find dental literature online?
c. Dental town
d. google Ans.A
Q. Which of the following exhibits the MOST personal behavior by the dentist
A. leaning toward the patient
B. facing directly toward the patient
C. being seated 2 feet from the patient
D. touching the patient gently on the arm Ans.D
Q. which is the acronym for a patient management system?
c. optimum Ans.C
Q. persistent and repetitions questions asked by an 8 years old patient during treatment are ?
a. attempted to delay treatment
b. medication of hyperactivity
c. sign that child may be autistic
d. expression of the child’s curiosity about the dental treatment Ans.A