05/13/2015

Dentists get dental benefits lesson at CDA workshop


Attendees of CDA’s recent Dental Benefits Workshop at the CDA headquarters in Sacramento had the opportunity to earn C.E. credits while learning how to analyze and evaluate existing dental plan contract performance in their practices.

The more than 70 people, including dentists and staff from 40 practices, who attended the April 16-17 event earned up to 12 hours of C.E. and improved their skills in analyzing and evaluating the dental benefit marketplace. They also learned the differences between plan types and how to abate their influence, improve payment turnaround by minimizing claim denials and develop messaging for educating patients regarding their dental benefits.

Maria Stefan, DDS, has practiced in Stockton since 2001. She attended the Dental Benefits Workshop to find ways to improve her office’s performance.

“I learned a lot about different types of practices, different models of practices,” Stefan said. “We are interested in changing the model that we practice, to offer better quality dentistry to our patients … Just be more productive, more efficient.”

Michael Perry, DDS, CDA director of practice management, held a lecture at the workshop on practice model selection.

“Our goal is to help them understand what is happening in the marketplace and to help them gain a knowledge base that they can use to make individual decisions,” Perry said.

Perry broke down the relationship with dental insurance into certain categories that he calls models of practice depending upon how much contracted insurance the practice has.

Below are the models:

  • Model 1: Hybrid — 2/3 fee-for-service, 1/3 PPO.
  • Model 2: Hybrid — 1/3 fee-for-service, 2/3 PPO.
  • Model 3: Hybrid — 1/4 or less fee-for-service, 3/4 or more PPO and/or HMO.
  • Model 4: Pure fee-for-service.

Jenny Dirks, RDA, is the treatment coordinator for the practice of Edward Montalbo, DMD, in Sutter Creek. Montalbo wanted his staff to attend last year’s CDA Dental Benefits Workshop, but it was full. This year, he registered early to make sure his team could make it. Dirks said Montalbo wanted his staff to learn more about dental insurance and how they can run more efficiently as a practice.

Dirks said the practice plans to look into changing the model of their practice after attending the workshop.

“We're going to work on maybe changing the model, that was very informative and interesting,” Dirks said.

Other topics led by experts in various fields included provider contracting, patient education/communications, electronic dentistry and claims processing.

Gary Dougan, DDS, MPH, led the lecture titled “Secrets of Smoother Claims Processing.”

“Since codes do change annually now, it’s a real challenge for dental office staff and dentists to be up on all the latest code changes, but that can make a big difference in your success,” Dougan said.

A CDA survey was sent to the attendees after the workshop. Of those who responded, 96 percent said they were either “very satisfied” or “somewhat satisfied” with the workshop and 92 percent said if they required additional seminars in dental benefits they would either “definitely” or “probably” choose CDA as the educational provider.

From claims paperwork to health care reform, there was a lot to cover over the two-day event. CDA used research and included a variety of dental professionals (plan representatives, practice management experts, etc.) to plan and execute the curriculum for the workshop.

Previous dental benefit/plan research has revealed that dentists are extremely frustrated with the dental benefits world and consider this a great source of frustration. The research also identified that dentists’ aggravation is related to claims denial, down coding, benefit exclusions and a number of other procedural matters that oftentimes could be avoided through better training and education of dental office staff responsible for filing claims. Additionally, many dentists are unaware of the nuances of the contracts they have signed with the dental plans and their rights, limitations and obligations under those contracts.

Through education and training, the Dental Benefits Workshop will attempt to relieve some of these frustration points.

The next Dental Benefits Workshop will take place in Irvine on Oct. 22-23. Participation is limited and only two people from each practice will be accepted on a first-come, first-served basis (one dentist and one staff member). The workshop costs $495 per practice and includes breakfast and lunch both days. Attendees are responsible for travel and lodging costs.

Dentists who would like to participate in the Irvine Dental Benefits Workshop can register at cda.org/dbw.

For CDA Practice Support resources and more information on dental benefits, visit cda.org/practicesupport.



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What to consider when offering discount dental plans
By Greg Alterton, CDA Dental Benefit Plan Specialist
As the Affordable Care Act continues to change the health care landscape, one option that has emerged for dentists is to make care available to patients using a discount dental plan. Discount dental plans operate much like Costco or other large membership retailers: a membership fee is charged for the ability to purchase services at a discount below the standard customary fees charged for dental care.

In March 2014, CDA piloted the Dental Benefits Workshop, a two-day program for dentists that provided the necessary tools and insight into the challenging world of dental benefit plans. In attendance were 40 dentists who were hand-selected to participate in the pilot program based on several criteria, including number of years in practice, current participation level with dental benefit plans, practice demographics, etc. A six-month post-workshop survey of the March 2014 workshop attendees showed decreased claim denials and improved patient communication, among other things.

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