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Dental Benefit Plans
Coverage through dental benefit plans is one of the primary ways patient care is funded and being able to navigate the dynamic world of dental benefit plans is one key to managing a smart practice. Utilizing the resources included here, you will learn how to navigate the unique requirements of provider agreements, manage and file dental claims efficiently and effectively, improve your understanding of your appeal rights as a dentist and much more.
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This guide identifies many of the key policies necessary to comply with the Denti-Cal program’s requirements. It will help dentists navigate the program and ensure prompt payment and program compliance.
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The California Business and Professions Code Section 732 outline the following guidelines for handling credit balances: “A dentist shall refund any amount that a patient has paid for services rendered that has subsequently been paid to the dentist by a third-party payer and that constitutes a duplicate payment. The refund shall be made as follows:    Read more >>
One of the most frequently asked dental benefit questions we receive in the Practice Support Center has to do with payment for incomplete treatment.    Read more >>
The Centers for Medicare & Medicaid Services (CMS) requires providers and billing staff who render services to Medicare Advantage enrollees to complete Fraud, Waste and Abuse (FWA) training annually. The training also meets the contractual obligation providers have with dental plans such as Delta Dental and Aetna.    Read more >>
Between implementation of the Affordable Care Act, the fiscal cliff that our country is dangling from and the tentative state of the economy, it is anyone’s guess as to the direction California is headed for 2013. Based on what we’re hearing and reading, here are some predictions of what one can anticipate in the dental benefits world in the New Year:    Read more >>
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Ann Milar Ann Milar  
Dental Benefits Analyst

916.554.4994
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Tip of the Week

If a computer hard drive, laptop or other electronic media with patient information is stolen or lost, the dental practice does not need to comply with the state and HIPAA breach notification rule if those items are encrypted.