05/26/2015

Anthem Blue Cross announces provider fee reduction


Anthem Blue Cross has notified CDA that it is making changes to participating dentist agreements and is currently in the process of notifying impacted providers of “fee adjustments” that will go into effect Aug. 1. A CDA-sponsored law requires insurers to provide no less than 45 business days’ notice of any material change to contracts or payment plans.

According to Anthem, those rate reductions impact the PPO/100, PPO/200 and PPO/300 networks of general dentists and certain specialists (endodontists, oral surgeons, pediatric dentists and periodontists) in specific geographic areas, including Kern County, Los Angeles County, Riverside County, San Bernardino County and San Diego County.

According to Anthem, the rate cuts will range from 8 to 10 percent for the maximum allowable tables. However, the percentage change does not apply to every CDT code and does not apply to every dentist in the region. Anthem said it will provide greater detail in the individual letters to affected providers. In January, Anthem implemented cuts of up to 6 percent for more than 7,700 dentists in the Bay Area and Los Angeles area.

Anthem stated that dentists with any questions regarding the rate reduction should call an Anthem network representative at 866.947.9398, 7 a.m.-4:30 p.m., Monday-Friday.

CDA understands the frustration and anxiety that members may experience regarding such rate reductions. As a member benefit, CDA offers practice management resources and dental benefits guidance through online Practice Support or at 800.232.7645.

CDA will continue to keep members informed about Anthem’s reimbursement rate reduction in the Update and e-newsletter and on cda.org as information becomes available to us.



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