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Dental Benefits Plans for the New Practice

August 16, 2021 1935

Consider how your practice will work with dental benefit plans. “Evaluating Dental Benefit Plans Checklist

Know your rights as they relate to dental benefit plans. Start by reading “The Dental Benefit Plan Handbook.”

Identify dental benefit plans in your area by contacting employers near your dental office or in your community. You can also refer to “California Department of Managed Health Care Licensed Dental Plans” to view various lists of plans. Visit each plan’s website to find out how you can enroll as a provider. The ADA CDT Dental Procedure Codes book contains billing codes. A companion book provides guidance for different coding scenarios. Order by calling 800.947.4746 or visit ebusiness.ada.org.

Use the “Dental Benefit Plan Handbook” to train staff and/or educate yourself on the ins and outs of working with third-party payers. Sample forms and letters are included in the handbook.

Use the “Evaluating Dental Benefit Plans Checklist” and calculator to determine the financial impact of participating in or dropping a plan.

Review for Are you in Compliance? for information on Medicare enrollment and to determine if you want to opt in, opt out or become an ordering and referring provider.

Review all dental benefits plans’ agreements prior to execution of any agreement.

Before you sign a dental benefit contract, contact a CDA Practice Support Dental Benefit Plan expert to facilitate ADA dental benefit contract analysis.