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.

Learn about your rights and actions you must take when dealing with refund demands made by dental benefit plans.

Understand the elements of the Explanation of Benefits and what to look for.

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.

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.

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.

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.

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.

Defines the types of plans to consider for your practice, contracting & contract analysis, billing & how to establish fees and more.

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.

CDA offers a variety of tools to help you easily navigate the transition into your new profession and your early years.

Requirements and best practices when separating an employee from employment.

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. 

This toolkit covers recruiting, interviewing, hiring and onboarding, and provides a general list of basic hiring documents. 

Associates may be classified as either an independent contractor or an employee. This toolkit includes information to help you determine how to hire an associate.

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.

In this article you will learn how to weigh the costs before you sign a dental benefit participating provider agreement/contract.

Dentistry is an ever-evolving field, and CDT codes are critical to the everyday workings of dental practices.

This letter may be used to notify Third Party Payers when a temporary dentist will be filling in for dentist out on leave.

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.

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.

Form to aid dentists in verifying their patients' dental benefits in order to provide the best possible treatment estimate.

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.

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.

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.