Every July, CDA Practice Support starts hearing from members who have received notice from a dental benefit plan about a forthcoming audit. CDA's dental benefits analyst explains the post-pay audit, when dentists must participate in the audit and dentists' right to appeal the findings.
CDA Practice Support continues to hear from member dentists impacted by Delta Dental of California’s contractual change under Participating Dentist Rule 2, Basis of Fees that took effect September 15, 2018. Dental practices can take action annually to avoid negative impacts.
CDA Practice Support answers a member's question about whether a noncontracted dental benefits plan has a legal right to the contracted fee discount of another plan that the dentist does have a contract with.
With baby boomers exiting the workforce and losing their employer-sponsored dental coverage, consumers are enrolling in Medicare, the federally administered health care program for all seniors age 65 and older. Practice Support has seen an uptick in member calls related to Medicare Advantage dental plans due, in part, to the aging patient population in their practices and increased Medicare enrollment.
Adding or dropping a contract with a dental benefit plan is a personal business decision. There is no “one size fits all” in these types of business decisions, as what might work for one dentist might not work for another. You may be asking yourself how a dentist can make a good decision about adding or dropping a dental plan/network participation, but there is one key element in each success story.
Dentists can avoid unnecessary stress by seeking guidance from CDA Practice Support before complying with a dental benefit plan’s request to conduct a post-payment chart review of patient records.
Beginning in the New Year, and with the forthcoming issue of the CDA Update, the dental benefits column will host a semiregular series discussing basic dental benefit issues. The topics covered address questions that CDA Practice Support receives from dental offices and from local dental components. This first installment addresses proper billing for treatment provided by an associate and waiving of co-payments.