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Dental Benefit Plans

Coordination of benefits, fees/discounts/refunds, appeals, billing and contracts.

Coverage through dental benefit plans is the primary way patient care is funded. The ability to navigate carriers and plans is key to managing a successful practice. Use these resources to help you navigate provider agreement requirements, manage dental claims, improve your understanding of appeal rights and more.

Delta FAQs: Upcoming Delta Dental Rate Reduction For Specialist Providers

In February 2020, CDA was notified by Delta Dental of California that it will reduce fees for periodontists, endodontists and oral surgeons in its Premier provider network effective July 1, 2020. Read the FAQs below to understand potential effects of this

Delta Dental Litigation

CDA has achieved a favorable settlement on behalf of dentists in our litigation against Delta Dental. CDA took a stand on your behalf — to protect your right to fair dealings — and we succeeded.

Clinical Chart Documentation Guidelines

This guide demonstrates patient record best practices. Thorough and accurate patient records are one of your most important tools for telling the story of what happens during treatment.

Discount Dispute Letter (Multiple Benefit Plans)

This sample letter is for use to respond to a dental plan you are not contracted with claims related to the fee discount of a plan with which you are contracted.

Is it a covered benefit? Understanding the noncovered services law (Article 9/26/2018)

Understand the CA law that regulates what dentists can charge patients for procedures that the policy does not cover AB 2275.

Billing dentists: Learn how to properly bill when another dentist performs treatment (Article 3/28/2019)

Understand the risks involved in billing improperly during practice transitions.

Dental Benefit Plan Handbook - Chapter 6 Completing and Filing the Claim Form

Common reasons for claim delays and denials; correct use of procedure codes, Tax Identification (TIN) and National Provider Identification (NPI); practice’s fee schedule and radiographic image attachments; electronic claim (E-Claim) filing.

Considerations When Billing for an Associate

Overview of the payment arrangements to consider once an Associate begins providing treatment in a dental practice.

Professional Courtesy for Dental Treatment: An Employee Benefit

As a contracted provider in a dental plan, under what circumstances can a dentist waive patient/employee responsibility for co-pays, deductibles and non-covered services?

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