Member benefit supports practices' business side

Mireya Ortega, DDS, thought she had taken all of the necessary steps in the insurance approval and billing process for her patient. But despite doing everything according to the insurance policy standard (getting preauthorization, confirmation of coverage and billing exactly what services were provided) she was sent a letter in the mail informing her she needed to return all of the money she had received for the treatment because the patient in fact did not have coverage.

Ortega stood to lose thousands of dollars. When she called the insurance company she was told she couldn't obtain details of why the claim was rejected after it was initially approved because of patient privacy issues. After three to four months of back and forth, Ortega knew she needed help in resolving this issue.

"I called the CDA Practice Support Center and they were instrumental in helping me with this," said Ortega, who has been a general practitioner in South Lake Tahoe since 1999 and a CDA member since she graduated from dental school.

A CDA Practice Support analyst sent her templates for letters she could send the insurance company and informed her of a court case that protected her in such a situation. This put the onus on the insurance company to determine why coverage was initially approved and then rejected after the treatment occurred.

"Once I sent the letter that CDA Practice Support supplied the template for, the insurance left me alone and stopped asking me to refund the money," said Ortega, who has been utilizing CDA Practice Support since its launch in 2009. "I had been trying to resolve that for three to four months and CDA helped me end it within about a month."

There are countless stories just like this of CDA members who regularly take advantage of CDA Practice Support, which is an exclusive member benefit and includes hundreds of online resources geared toward the dentist who needs general support with running the business side of a practice. Resources are available in topics such as practice management, employment practices, dental benefit plans and regulatory compliance. In addition, members can contact a practice analyst over the phone or through email.

CDA Practice Support was created as a direct result of member-driven research and feedback, and was intended to be an "extension of the dental office." CDA has fulfilled that goal over the last six years by building it into a vast repository of more than 600 practice management resources, including fax forms for medical releases, consent forms, new patient forms and scripts on how to talk to a patient about their financial agreements.

Most recently, Ortega has been calling CDA Practice Support for advice on the new sick leave law (employers had to begin providing mandatory sick leave to all employees on July 1, or on the first day of employment for new employees — whichever is later.)

"I think CDA Practice Support is the best thing that's happened in a long time to CDA membership," Ortega said.

Since its launch in 2009, the number of calls/emails from members to CDA Practice Support has increased from 6,100 annually to more than 24,000 in 2015. Further, visits to the website have increased from 51,000 in 2009 to nearly 100,000 in 2015.

At cda.org/practicesupport, members can find sample business plans to help detail and document a dentist's vision for their practice as well as step-by-step checklists for opening, transferring ownership of or closing a practice. Dentists in the job hunt can find advice on how to write job descriptions and create applications. Dentists already working at a practice can find information on how to place help-wanted ads, set meal breaks, establish alternative work schedules and terminate an employee.

"It can be difficult for dentists to juggle all of the things that go into running a successful practice, and that is where CDA Practice Support comes in," said Scott Szotko, DDS, chair of the Council on Practice Support.

The 2015 Sample Employee Manual, which can be customized to any practice, is the most popular resource in 2015 (in 2009, the most popular resource was the Starting a Practice Checklist).

Junie Baldonado, DDS, recently purchased a practice and has been using CDA Practice Support for everything from employee relations to regulatory compliance and employee manuals. What he has learned from these resources and his interactions with CDA Practice Support analysts has helped him in his transition from being an associate to a first-time practice owner.

"We learned very little about running a business in dental school. CDA has really helped me out," Baldonado said.

Baldonado had been dealing with the fact that he wasn't allowed to talk to the practice's current patients or staff up until a few days before the deal closed, which was May 1 — the same day he opened.

"Most acquisitions occur in such a way that hinders or blocks the buyer from meeting the current staff and patients of the practice until right before or after the deal closes — this was my situation," Baldonado said. "Therefore, there is very little to no transitional period for the buyer to get to know the nuances of the practice, making it difficult for everyone involved."

Purchasing a practice is just one of the many topics discussed in the "Ask an Expert" section of cda.org/practicesupport. Here, dentists can ask questions to a CDA Practice Support expert, such as, "How do I create a cellphone policy for my office?" or, "Where can I find the latest OSHA posters to post in my break room?"

CDA President Walt Weber, DDS, encourages more members to take advantage of what CDA Practice Support has to offer online and by picking up the phone and calling a CDA Practice Support analyst.

"There are issues that may arise in your practice, whether it be hiring or firing an employee or getting all of the details on the latest regulatory requirements, that come up unexpectedly and you don't want to have to worry about these types of things because what you really want to focus on is simply providing good oral health care for your patients," Weber said. "CDA Practice Support can be your helping hand when it comes to making your business function smoothly."

To learn more about CDA Practice Support, visit cda.org/practicesupport. Dentists who plan to attend CDA Presents The Art and Science of Dentistry in San Francisco in August can also stop by the Member Benefits Center on the exhibit hall floor at Moscone South to speak to an analyst.

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