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Dental Benefit Plans

Use our resources to navigate the requirements of provider agreements, file dental claims and better understand your appeal rights as a dentist. If you experience challenges, you can submit your dental benefit plan issues online for review.

Uptick in Quality Assessment audits by Delta Dental of California

CDA has received an influx of member inquiries regarding the recent wave of Delta Dental of California’s Quality Assessment audits. On-site reviews are part of Delta Dental’s Quality Assessment program for contracted dentists in California, mandated by the California Department of Managed Health Care. These reviews evaluate many components of a practice compared to the expectations of dental professionals, regulatory agencies and Delta Dental.

Teledentistry Consent and Notice

This form serves both as a notice that complies with the Dental Board’s requirement and to obtain informed consent for teledentistry.

Patient Request to Restrict Disclosure of Patient Health Information to a Dental Benefit or Health Care Plan

Includes information on this patient right to restrict disclosure of patient health information to a dental benefit or health care plan and a sample form to use for a patient who requests such a restriction.

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Resource Library

Access an online library of downloadable articles, guides, templates, checklists and forms.

Dental Benefit Plan News

Massachusetts ballot measure on dental plan spending passes decisively

In Tuesday’s election, Massachusetts voters overwhelmingly supported a ballot measure that will require Massachusetts dental plans to spend at least 83% of premium dollars on patient care rather than administrative overhead costs and executive compensation. 
 

Expanded Medicare coverage of medically necessary dental services begins in 2023

The Biden administration this week expanded coverage for medically necessary dental procedures in Medicare. Coverage of some services — specifically, elimination of infection preceding an organ transplant and certain cardiac procedures — will begin in 2023, while coverage of dental services linked to head and neck cancers will start in 2024.  

Dentists can use CDA's new Practice Health Check to evaluate dental plan participation this fall

Every quarter, CDA publishes a Practice Health Check focusing on a different topic related to the business side of dentistry. Evaluating dental benefit plan fees, costs and billing tools is the focus during the fourth quarter of 2022. CDA members are invited to take the Q4 Practice Health Check consisting of just three questions.