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
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
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. View resource Discount Dispute Letter (Multiple Benefit Plans)
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
Retroactive Eligibility Refund Demand and Dispute This resource provides information on the state law regarding refund demands from a benefit plan when a patient's coverage has been retroactively terminated. Includes a sample letter to dispute a refund request from a benefit plan after the plan has paid for services rendered. View resource Retroactive Eligibility Refund Demand and Dispute