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SAFEGUARD HEALTH PLANS, INC. -1992
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SAFEGUARD HEALTH PLANS, INC. -1992
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Last modified
6/19/2014 3:15:58 PM
Creation date
11/18/2010 7:40:34 AM
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Contracts
Company Name
SAFEGUARD HEALTH PLANS, INC.
Contract #
A-1992-114
Agency
Personnel Services
Council Approval Date
9/8/1992
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i <br />LIMITATIONS <br />Dentures: (full or artia : e .tures r app lances �iil e replaced only after 3 <br />etu p <br />have elapsed following are prior provision o such dentures if appliances <br />Years p p <br />under any Safe and program., Replacements will e made only if the existing <br />ud .� ,p <br />denture pp <br />or appliance is unsatisfactory and cannot e made satisfactory. <br />2. Denture Refines} Twice a year. <br />3. Prophylaxis: once every six months. <br />4. Full mouth x-rays: once initially and Hereafter when diagnostically necessary. <br />5, Fluoride Treatment; once every 6 months to age 18. <br />6. Reimbursement shall not be made for the cost of services secured from any other <br />authorized � �r�t�r� <br />health care provider other than the member's Provider, unless g <br />by Safeguard, <br />7. Crowns or replacement of missing teeth mith complete or partial dentures or fixed <br />bridges are provided using standard procedures. <br />CA 4/91 <br />
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