B

B

bad faith insurance practices: The failure to deal with a beneficiary of a dental benefit plan fairly and in good faith; or an activity which impairs the right of the beneficiary to receive the appropriate benefit of a dental benefits plan or to receive them in a timely manner.  Some examples of potential bad faith insurance practices include: evaluating claims based on standards which are significantly at variance with the standards of the community; failure to properly investigate a claim for care; and unreasonably and purposely delaying and/or withholding payment of a claim. See prompt payment laws.

balance billing: Billing a patient for the difference between the dentist’s actual charge and the amount reimbursed under the patient’s dental benefit plan.

barrier membrane: Usually a thin, sheet-like usually non-autogenous material used in various surgical regenerative procedures.

behavior management: Techniques or therapies used to alter or control the actions of a patient who is receiving dental treatment. Examples include use of a papoose board, education or anxiety relief techniques.

beneficiary: A person who is eligible for benefits under a dental benefit contract. See also covered person, insured, and member.

benefit: The amount payable by a third party toward the cost of various covered dental services or the dental service or procedure covered by the plan.

benefit booklet: A booklet or pamphlet provided to the subscriber that contains a general explanation of the benefits and related provisions of the dental benefit program. Also known as a Summary Plan Description.

benefit plan summary: The description or synopsis of employee benefits as required by ERISA that is to be distributed to the employees.

benign: The mild or non-threatening character of an illness or the non-malignant character of a neoplasm.

bicuspid: A premolar tooth; a tooth with two cusps.

bilateral: Occurring on, or pertaining to, both right and left sides.

biologic materials: Agents that alter wound healing or host-tumor interaction. Such materials can include cytokines, growth factor, or vaccines, but do not include any actual hard or soft tissue graft material.  These agents are added to graft material or used alone to effect acceleration of healing or regeneration in hard and soft tissue surgical procedures.  Also known as biologic response modifiers.

biopsy: Process of removing tissue for histologic evaluation.

birthday rule: When a dependent child’s parents both have dental coverage, this rule states that the primary program (the one which pays first) is the one covering the parent whose month and day of birth falls first in the calendar year. The birthday rule is the most common rule for determining primary v. secondary coverage, but it may be superseded by a court order such as a divorce agreement.

bitewing radiograph: Interproximal radiographic view of the coronal portion of the tooth/teeth.  A form of dental radiograph that may be taken with the long axis of the image oriented either horizontally or vertically, that reveals approximately the coronal halves of the maxillary and mandibular teeth and portions of the interdental alveolar septa on the same image.

bleaching: Process of lightening of the teeth, usually using a chemical oxidizing agent and sometimes in the presence of heat.  Removal of deep seated intrinsic or acquired discolorations from crowns of vital and non-vital teeth through the use of chemicals, sometimes in combination with the application of heat and light.  Bleaching has been achieved through short and long term applications of pastes or solutions containing various concentrations of hydrogen peroxide and carbamide peroxide.  Normally applied externally to teeth; may be used internally for endodontically treated teeth.

bonding: Process by which two or more components are made integral by mechanical and/or chemical adhesion at their interface.

bounded tooth space: See tooth bounded space.

bridge: See fixed partial denture.

bruxism: The parafunctional grinding of the teeth.

buccal: Pertaining to or toward the cheek (as in the buccal surface of a posterior tooth).

bundling of procedures: The systematic combining of distinct dental procedure codes by third-party payers that results in a reduced benefit for the patient/beneficiary.

by report:  A written description of  the service provided that is prepared when the term “by report” is included in a procedure code nomenclature; may be requested by a third-party payer to provide additional information for claims processing.