Recent law changes effecting the California Department of Insurance
The California Department of Insurance requires insurers and health plans licensed under the State Insurance Code to provide internal dispute resolution mechanisms for health care providers to challenge adverse payment decisions. Upon completion of the internal review, if the care provider still disputes the insurance company’s payment decision, the dispute can be filed with the Consumer Services Division of the Department of Insurance. The department provides a form that dentists may file with the department. It’s also important to remember that patients may also file a complaint with the Department of Insurance over a payment dispute with their insurance company. Because of the department exists mainly to protect consumers, dentists should be encouraged to share pertinent information with their patients when a payment dispute arises with a patient’s insurance company. Click here for more information.