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 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 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 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 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
Pause before you comply with a plan's request for post-payment chart review 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. View resource Pause before you comply with a plan's request for post-payment chart review
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
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
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
Sample Letter to Third Party Payer for Temporary Dentists This letter may be used to notify Third Party Payers when a temporary dentist will be filling in for dentist out on leave. View resource Sample Letter to Third Party Payer for Temporary Dentists
Prevent Billing Problems and Stress During Leaves of Absence Understand how a dentist's absence in the practice could result in dental claim processing issues and how to develop a plan of action to reduce complications. View resource Prevent Billing Problems and Stress During Leaves of Absence
Evaluating Dental Benefit Plans Checklist Checklist to help guide a dentist in determining if participation with a new plan fits their model/scope of dentistry, and what to review when evaluating existing plans accepted in the dentist. View resource Evaluating Dental Benefit Plans Checklist
Benefit Breakdown Form Form to aid dentists in verifying their patients' dental benefits in order to provide the best possible treatment estimate. View resource Benefit Breakdown Form
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
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
Conducting a Self-Audit Info on practice management audits: practice strategic plan, production goals and revisions to schedule, chart audit, financial audit, billing, and how to update management policies and procedures. View resource Conducting a Self-Audit
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
What You Need to Know About Dropping Dental Plan Contracts A guided checklist to assist dentists with things to consider before, during and after withdrawal from a plans network, including sample letters for use in your practice. View resource What You Need to Know About Dropping Dental Plan Contracts
Payment Dispute Resolution Forms and Processes There are two levels for appealing payment disputes: first with the plan itself, then with the appropriate regulatory agency. This resource provides a detailed list of contacts and appropriate processes to follow. View resource Payment Dispute Resolution Forms and Processes
Patient Records - Requirements and Best Practices Format and content, patient access to records and requests to amend, disclosure of information, data breach notification, retention and disposal, transferring records in a sale. View resource Patient Records - Requirements and Best Practices
Financial Agreement and Consent Form Tool to utilize during the patient financial discussion to document financial options presented, patient obligation and financial consent. View resource Financial Agreement and Consent Form
Professional Courtesy for Dental Treatment: An Employee Benefit Outlines sample policy language and considerations for billing when employees have dental benefit plan coverage. View resource Professional Courtesy for Dental Treatment: An Employee Benefit
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. View resource Uptick in Quality Assessment audits by Delta Dental of California