Indications for and claims to dental specialties: case studies
In the second part of this two-part article on dental specialties, the application of article 2.7 of the Healthcare Insurance Decree is explained on the basis of cases relevant to the clinical practice. While part 1 describes the legal parameters, this article addresses daily decision-making in the general dental practice. When reimbursement can be claimed and when it cannot, within the regulatory framework for dental specialties, is illustrated on the basis of examples from prosthetic and implant practice. The distinction between treatment indication and the right to reimbursement, and its application, are central. With this, dentists are offered guidance on indication, applications for authorization, and communicating with patients, with the aim of preventing incorrect referrals and disappointment, and promoting the effective use of the regulatory framework for dental specialties.