Page 64 - Dental Benefit Plan Summary
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TEXAS MUTUAL INSURANCE COMPANY DENTAL PPO PLAN
Usual and Customary fees are determined solely in accordance with reimbursement policy
guidelines. The reimbursement policy guidelines are developed following evaluation and
validation of all Dentist billings in accordance with one or more of the following
methodologies:
■ as indicated in the most recent edition of the Current Dental Terminology (publication
of the American Dental Association);
■ as reported by generally recognized professionals or publications;
■ as utilized for Medicare;
■ as determined by dental staff and outside dental consultants; or
■ pursuant to other appropriate source or determination.
59 SECTION 11 - GLOSSARY
