Most of the patients you see this year will rely heavily on their dental plans to assist with covering a portion of the cost of treatment. The National Association of Dental Plans reported in 2022 that nearly 280 million Americans, or 85% of the population, were covered by some type of dental benefit. This statistic is a marked increase from five years ago, when the same organization reported that 77% of Americans had dental benefits. California residents are just slightly above the national percentage, with 86% of residents having some type of dental coverage.

As the number of patients using dental coverage steadily rises, dentists still wrestle with the question of whether contracting with dental plans is advantageous for their practice. In a 2021 survey of dental professionals conducted by CDA, insurance or dental plan reimbursements were cited as the top concern, outpacing the cost of dental school and staffing shortages.

Despite the concerns dentists have about dental plan reimbursements, most recognize that accepting dental insurance is of value to their patients. Many dental patients seek service that goes beyond the treatment chair and look for a dentist who is contracted with their plan, communicates in advance about covered services, provides treatment plans and files claims.

CDA engages in legal and legislative advocacy

Recognizing that working with dental plans is challenging from both a patient service and practice standpoint, CDA is actively working through multiple approaches to support dentists navigating the dental benefit landscape.

On behalf of dentists across California, CDA recently took legal action against one large dental plan to require that plan to meet its contractual obligations.

Additionally, CDA is sponsoring legislation to increase dental plan transparency by requiring appropriate notification to patients and dentists of whether a plan is state or federally regulated.

CDA offers dental benefit expertise

Another important benefit of your CDA membership is access to a variety of resources and trusted expertise designed to help you understand requirements of provider agreements, file dental claims properly, better understand your appeal rights as a dentist and analyze plan provider contracts. Members can utilize online educational materials, take courses or connect with experts to answer questions specific to their practice.

Here’s a quick look at some of the tools CDA provides to support you when working with dental plans.

• Dental benefit plan resource library. Answers to questions about appeals, audits, billing, claims, coordination of benefits and more can be found in our robust library of articles, forms, guidelines and the most recent news about legislation and industry trends.
• Dental Benefit Plan Handbook. CDA’s experts took the sometimes-overwhelming information on dental benefit plans and broke it down into digestible chapters. Designed to guide you through the dental plan landscape, this handbook is an excellent tool for any member of the dental team who wants to familiarize themselves with the basics of dental benefits.
• Dental Benefit Issue Form. Have a question about dental plans that you can’t find an answer for in our resource library or handbook? This is a convenient way for dentists (or their designee) to submit issues to CDA and request assistance from our expert analysts.
• Dental benefits courses at CDA Presents in Anaheim. CDA’s Practice Support Team will be on site to offer their expert advice and instruction to dental professionals looking for dental benefit information and resources. Add one of the following courses to your schedule when you register to attend our event this May.
  • To Contract or Not to Contract? Working with Dental Benefit Plan Contracts | Friday, May 19, at 3 p.m.
  • Ask the Expert – Dental Benefits | Saturday, May 20, at 12 p.m.
• Benefit Plan Consulting. A new service available to CDA members, the benefit plan consulting service is designed to help dentists better understand dental plan provider contracts in relation to their patient base, procedure mix and fees. A dentist is paired with an expert analyst for a customized analysis of a dental plan provider contract. After a thorough evaluation, the analyst provides an overview of the results and offers guidance unique to the dentist’s practice, patient demographic and preferred business model. The consulting service is a convenient, cost-effective option with no long-term contracts or retainers.

Feedback from your peers

CDA members who used the new Benefit Plan Consulting service found it an invaluable tool for their dental practice.

“It was a game changer for me once I had my consultant lay it all out,” one practice owner, Dr. Andrea R. Cervantes, said about her experience. “It has changed my entire practice structure for the better. The savings were well worth the consultation fee. I highly recommend that all practice owners take advantage of this service. The entire process is simple and takes only a matter of weeks to get your results. The consultants are well informed about the issues of running a private practice and provided suggestions for moving forward.”

Another practice owner, Dr. Matthew Thunberg, shared his experience with Benefit Plan Consulting.

“As a business owner, my focus is on the day-to-day operational data such as production and collections and monthly data such as payroll costs, lab and supply costs and occupancy costs. I didn’t feel that I had the time or knowledge to extract the specific data needed to make a proper analysis of the dental plan,” he explained. “The Benefit Plan Consulting exceeded my expectations, and I would absolutely recommend this service to a colleague. The team did an exceptional job of creating my ‘Treatment Plan.’ The cost for the experience and guidance that CDA provided makes this a well-priced service.”

Dental benefit plans can be intimidating, but with CDA’s support, you can navigate them with confidence. Whether you are deciding if you should or should not accept patient insurance or need advice on insurance contracts, rely on CDA’s dental benefit plan resources and experts for advice and education.