Abstract
The article clarifies the distinction between "non-covered" and "disallowed" services in dental plan audits. Non-covered services are not included in the patient’s dental plan, often due to plan limitations, while disallowed services are covered but deemed non-payable due to issues like claim deficiencies or lack of documentation. Dentists must review their contracts to understand obligations regarding non-covered services and ensure compliance with HIPAA for patient-paid services. For disallowed services, contesting decisions may be possible depending on the agreement with the dental plan.
Recommended Citation
Schulte, Daniel JD
(2025)
"Dentistry and the Law: The Difference Between ‘Non-Covered’ vs. ‘Disallowed’ Services,"
The Journal of the Michigan Dental Association: Vol. 107:
No.
1, Article 3.
Available at:
https://commons.ada.org/journalmichigandentalassociation/vol107/iss1/3
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