Adding a Dentist to a Dental Plan as a New Provider It is required to notify dental plans of a new provider treating patients in the office. This resource provides information and a sample letter that can be customized and printed on office letterhead when informing dental plans of a new provider. View resource Adding a Dentist to a Dental Plan as a New Provider
Benefit Breakdown Form The quickest and easiest way to verify dental benefits for your patients is through the dental plans’ convenient online portal access where you can view, download, and print a patient’s benefit breakdown. This form may be used when verifying patients' dental benefits via telephone or to supplement the information provided on the dental plan’s online portal. View resource Benefit Breakdown Form
California Department of Managed Health Care Licensed Dental Plans As a member service, CDA has compiled a list of dental plans from the Department of managed Health Care website. View resource California Department of Managed Health Care Licensed Dental Plans
California Department of Managed Healthcare - Information on Provider Complaints After filing a provider dispute/complaint/appeal with a dental plan, learn how to file a 2nd level provider complaint with the California Department of Managed Healthcare. View resource California Department of Managed Healthcare - Information on Provider Complaints
CDA Business Associate Agreement An agreement that needs to be read and signed by the dentist when CDA will be handling Protected Health Information obtained from the dentist as we advocated on their behalf with dental benefit plans. View resource CDA Business Associate Agreement
CDA Member FAQ re: Delta Dental 2023 Contractual Changes Answers to members' questions about Delta Dental’s announced contractual changes announced for Jan 1. 2023. View resource CDA Member FAQ re: Delta Dental 2023 Contractual Changes
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. View resource Clinical Chart Documentation Guidelines
Considerations When Billing for an Associate Overview of the payment arrangements to consider once an Associate begins providing treatment in a dental practice. View resource Considerations When Billing for an Associate
Current CDT code books Dentistry is an ever-evolving field, and CDT codes are critical to the everyday workings of dental practices. View resource Current CDT code books
Delta Dental Litigation Summary 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. View resource Delta Dental Litigation Summary
Delta Dental: On-site Quality Assessment Review Checklist Use this list to compare aspects of a QA review with your practice's policies and procedures, and be even better prepared for a future on-site QA review. View resource Delta Dental: On-site Quality Assessment Review Checklist
Dental benefit contracting: It’s not all about the fees In this article you will learn how to weigh the costs before you sign a dental benefit participating provider agreement/contract. View resource Dental benefit contracting: It’s not all about the fees
Dental Benefit Plan Handbook – Chapter 01: Understanding Dental Benefit Plan Coverage Overview of the types of dental coverage and the differences between dental and medical coverage, in order to aid dentists in explaining dental coverage to patients. View resource Dental Benefit Plan Handbook – Chapter 01: Understanding Dental Benefit Plan Coverage
Dental Benefit Plan Handbook – Chapter 02: Understanding Dental Benefit Plan Contracts & Fees Defines the types of plans to consider for your practice, contracting & contract analysis, billing & how to establish fees and more. View resource Dental Benefit Plan Handbook – Chapter 02: Understanding Dental Benefit Plan Contracts & Fees
Dental Benefit Plan Handbook – Chapter 03: Verification and Explanation of Dental Benefit Coverage Tips for verifying coverage with a patient's plan and providing explanation to help patients interpret benefits, limitations, exclusions, financial responsibility and how to maximize coverage. View resource Dental Benefit Plan Handbook – Chapter 03: Verification and Explanation of Dental Benefit Coverage
Dental Benefit Plan Handbook – Chapter 04: Understanding Coordination of Benefits Understanding plan policies for coordinating payment of benefits when enrollees or policyholders have more than one dental benefit policy. Explanation of CA law pertaining to coordination of benefits. View resource Dental Benefit Plan Handbook – Chapter 04: Understanding Coordination of Benefits
Dental Benefit Plan Handbook – Chapter 05: Working with Patients and Their Plans Help patients understand the relationship the practice holds with plans; overview of: in network, out of network, pre-authorization, predetermination, discounts, dual coverage and claims. View resource Dental Benefit Plan Handbook – Chapter 05: Working with Patients and Their Plans
Dental Benefit Plan Handbook – Chapter 06: 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. View resource Dental Benefit Plan Handbook – Chapter 06: Completing and Filing the Claim Form
Dental Benefit Plan Handbook – Chapter 07: Billing Medical Plans Learn cross-coding: billing medical insurance in a dental office; how to select the correct CPT code and ICD-10 codes when billing medical plans. View resource Dental Benefit Plan Handbook – Chapter 07: Billing Medical Plans
Dental Benefit Plan Handbook – Chapter 08: Explanation of Benefits Understand the elements of the Explanation of Benefits and what to look for. View resource Dental Benefit Plan Handbook – Chapter 08: Explanation of Benefits
Dental Benefit Plan Handbook – Chapter 09: Managing Payment Problems Learn about your rights and actions you must take when dealing with refund demands made by dental benefit plans. View resource Dental Benefit Plan Handbook – Chapter 09: Managing Payment Problems
Dental Benefit Plan Handbook – Chapter 10: Understanding the Claim Appeal Process California law requires every dental plan to have a formal procedure that providers can use to dispute/challenge actions/decisions made by the plan. Overview of plan legal requirements, steps to appealing claims, filing a payment disputes. View resource Dental Benefit Plan Handbook – Chapter 10: Understanding the Claim Appeal Process
Dental Benefit Plan Handbook – Chapter 11: Understanding Dental Benefit Plan Audits Understanding dental plan authority in quality assurance assessment audits, requirements for the dental practice and best practices for patient records. View resource Dental Benefit Plan Handbook – Chapter 11: Understanding Dental Benefit Plan Audits
Dental Benefits – What You Need to Know This resource may be shared with patients to address some of the common questions about dental coverage and where to go when they are experiencing challenges with their dental plan. View resource Dental Benefits – What You Need to Know
Dental Plan Questions are Attempt to Ascertain Primary Payer Clarifying dual insurance and coordination of benefits "rules" when it pertains to the children of divorced parents. What questions to ask and the "rules" surrounding who is primary and secondary. View resource Dental Plan Questions are Attempt to Ascertain Primary Payer