Dental Benefits

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. 

Starting Oct. 31, dental providers must electronically submit Medi-Cal enrollment applications and required documentation through the online portal PAVE. Dentists can attend upcoming webinars to learn how to use the portal.

The California 2022-23 state budget signed by Gov. Newsom includes all of CDA’s priority asks with major investments in health care workforce development and $50 million to build and expand facilities and infrastructure to provide care for dental patients with special health care needs.

The California Department of Health Care Services plans to implement the Provider Application and Validation for Enrollment portal to simplify and accelerate Medi-Cal enrollment processes for dental providers no later than November 2022.

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. 

The U.S. Congress is working to finalize the details of President Joe Biden’s Build Back Better Act, and the framework of a final deal is near. While the details of the negotiated agreement have not been made public or acted on by Congress, it appears unlikely that a Medicare dental benefit will be included in the final legislation. 

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. 

A significant amount of activity is underway in the U.S. Congress focused on adding dental, vision and hearing benefits to the Medicare program, and the proposals are moving quickly. This communication from CDA supplements what the ADA, media and other sources have shared to give members background and context for the current activity and clarify some common misunderstandings.

Every July, CDA Practice Support starts hearing from members who have received notice from a dental benefit plan about a forthcoming audit. CDA's dental benefits analyst explains the post-pay audit, when dentists must participate in the audit and dentists' right to appeal the findings.

The California Legislature approved a state budget for the 2021-22 fiscal year that upholds the will of the voters when they passed the Proposition 56 tobacco tax in 2016. The budget makes significant investments in Medi-Cal Dental improvements, workforce development and coronavirus relief. 

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.

Cindy Hartwell, dental benefits analyst at CDA Practice Support, reviews how a dental practice can bill properly by registering all treating dentists in the practice with the dental plan or plans.