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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 new “CDT 2014” contains the Code on Dental Procedures and Nomenclature, which is the standard for recording dental services in patient records, on paper claim forms and on HIPAA standard electronic claim transactions. The new book is the only official source for the latest dental procedure codes. This blog serves as an overview of the upcoming changes.    Read more >>
Have you received an Explanation of Benefits (EOB) stating, “ The network savings were obtained through a relationship with Maverest DWP?” Were you anticipating reimbursement from Metlife and not familiar with any contract with Maverest? Is the reimbursement rate different from the contracted rate you have with Metlife?    Read more >>
The State Department of Managed Health Care recently reached an agreement with Anthem Blue Cross to pay physicians and other providers $3.2 million on improperly paid claims. It's a reminder of how the system of appealing payment disputes with plans works.    Read more >>
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 >>
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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.