Dental Benefit Plans
Coverage through dental benefit plans is one of the primary ways patient care is funded, and the ability to navigate the dynamic world of dental benefit plans is one key to managing a smart practice. Use the resources included here to 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 more.
Dental Benefits Issue Submission
Challenges with claim delays, denials and miscommunications? As a benefit of CDA membership, you can now share your issues working with dental benefit plans through a form that’s easy, quick and secure.

Log in to submit a Dental Benefits Issue Submission Form online at any time for expert analysis, evaluation and next steps. This new process enables Practice Support analysts to better facilitate resolution of your specific issue, while giving CDA a better view of the type and amount of benefits plan challenges faced across the membership.

To submit a form as a practice team member on behalf of a CDA member-dentist, call Practice Support at 800.232.7645 for assistance.

Resources by Topic

CDA members already have access to Practice Support’s full resource library. See dental benefits resources listed by topic below for help navigating common dental benefit plan challenges.

Minimize Carrier-Specific
Minimize Coordination of Benefits
Information and tools for billing for patients who have coverage through more than one plan, including California's coordination of benefits law and when non-duplication of benefits is applicable.

Dental Benefit Plan Handbook - Chapter 4 Understanding Coordination of Benefits (PDF)

In the News

See the latest posts below, and keep an eye out for the monthly dental benefits article on page 2 of each issue of the printed CDA Update.

Victory for direct-to-consumer orthodontic patient protection bill

10/14/2019
Direct-to-consumer orthodontic patients will gain new protections when CDA-supported Assembly Bill 1519 becomes the law in January 2020. The first of its kind in the nation, the new law will protect patients from DTC orthodontic companies that are putting profits before patients by taking potentially unsafe shortcuts to the accepted standards of care. Read more >>

 

Prepare for CDT 2020 dental code changes

09/25/2019
CDA encourages dentists to prepare for CDT 2020 dental code additions, revisions and deletions that go into effect Jan. 1, 2020. The new year will bring 37 new and five revised codes, plus six deleted codes. While dental plans are required to recognize current CDT codes, it is important to keep in mind that they are not required to pay for or provide benefits for the new or revised codes. Dentists should review each dental plan’s payment and processing guidelines to determine whether benefits will be payable. Read more >>

 

Contact
Cindy Hartwell Cindy Hartwell  
Dental Benefits Analyst

916.554.5941
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Tip of the Week
When sharing space with another dentist or having a specialist come to your practice to treat your patients, you should avoid financial arrangements that could be characterized as fee splitting. Fee splitting occurs when one healthcare provider pays the percentage of a patient’s fee to another healthcare provider, typically for a referral. If a specialist treats your patients in your office, you may only collect from the specialist the fair market value for the space, equipment, staff and supplies used.Check out the Guide to Dental Practice Act Compliance for more details and tips on compliance.