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.
Featured Resource
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.

Popular Resources
News & Blogs
As promised by Cigna Dental earlier this summer, Cigna contracted dentists across the country are receiving correspondence about the 2014 Cigna Cost Effectiveness Designation and Network Alignment. Participating Cigna Dental providers should have received a detailed letter including the contracting dentist’s Cost Effectiveness Designation (one to three stars) and the name of the Cigna network in which they participate, either Cigna Dental PPO Advantage (previously Core) or Cigna Dental PPO (previously Radius and participating Dental Network Savings Program providers).    Read more >>
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 >>
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Ann Milar Ann Milar  
Dental Benefits Analyst

916.554.4994
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Dental Benefit Plan Handbook
Tip of the Week
Are patients arriving for treatment unprepared for providing a payment? If so, be sure to complete a written financial agreement at every treatment plan discussion. Provide a copy of the agreement to the patient, which states payment is due before or at time of service.