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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News & Blogs
Have you received a re-credentialing packet from one of the Dental Plans? Is the office staff aware of what to watch for and the response time required? Does the dental plan have your current address information on file?    Read more >>
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 >>
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Greg Alterton Greg Alterton  
Dental Benefits Analyst

916.554.5384
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Tip of the Week
When changing your practice address or tax identification number, be sure to update the Dental Board of California, the NPPES (NPI registry) and any dental plans you may be contracted with and/or bill on behalf of your patients.