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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As dentists continue to struggle with the changing healthcare landscape, discontinuing participation with contracted dental plans is an increasing consideration for many in the profession. CDA recognizes that participating as a contracted plan provider is a decision that can only be made by individual dentists based on what is best for their patients and their practice.

This article will assist you with the implementation of plan withdrawal and provides sample letters for use in your practice.

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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

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If, after exposure to blood or saliva, an employee refuses to have a medical evaluation (offered by the employer at no cost to the employee), be sure to document the refusal.