Update 11/9/22: The CDA-endorsed ballot measure in Massachusetts – Question 2 – passed in Tuesday's election and will require dental insurance companies to spend at least 83% of premium dollars collected on dental services as opposed to using the money for administrative costs and executive compensation.
A proposed rule from the Center for Medicare & Medicaid Services would cover medically necessary dental services as part of the existing medical services benefit in Medicare. CDA last week submitted specific recommendations on coverage of services.
Reports from CDA members during the last week on contract change notification letters sent by Delta Dental of California raise additional concerns for CDA about the proposed changes.
Delta Dental of California is revising its Delta Dental of California Participating Provider Agreement effective June 1, 2022. Although described as an “enhancement,” the contract amendment alters reimbursement for Premier or PPO contracted dentists who treat DeltaCare® enrollees as out-of-network providers.
Do you have a question about a dental benefit issue? You can receive timely assistance from a CDA Practice Support expert. Simply submit your question online using the dental submission form available within your cda.org account.
CDA Practice Support continues to hear from member dentists impacted by Delta Dental of California’s contractual change under Participating Dentist Rule 2, Basis of Fees that took effect September 15, 2018. Dental practices can take action annually to avoid negative impacts.
Understand how a dental practice can bill properly by registering all treating dentists in the practice with the dental plan or plans.
Delta Dental of California’s proposed reductions to the “maximum allowable fees” for approximately 2,200 endodontists, periodontists and oral surgeons in California will not take effect July 1, as previously scheduled. Instead, Delta Dental has decided to indefinitely postpone the previously announced fee reductions.
CDA has heard from many specialist members — endodontists, periodontists and oral surgeons — who are facing reimbursement reductions under their Premier provider contracts with Delta Dental of California
CDA Practice Support answers a member's question about whether a noncontracted dental benefits plan has a legal right to the contracted fee discount of another plan that the dentist does have a contract with.
California Insurance Commissioner Ricardo Lara last Wednesday issued a notice to California health insurance and specialized health insurance companies, including 55 dental benefits companies, requesting that they “provide their policyholders with a partial premium refund no later than December 31, 2020.
CDA Practice Support is receiving calls from dentists and their staff concerning claim denials for scaling and root planing services by dental benefit plans. In this article, I review the criteria utilized by dental plans when reviewing claims for scaling and root planing and why some of the plan denials are correct based on the American Dental Association’s definition of scaling and root planing.
