Appeals
California Department of Managed Health Care Licensed Dental Plans
As a member service, CDA has compiled a list of dental plans from the Department of managed Health Care website.
California Department of Managed Healthcare - Information on Provider Complaints
After filing a provider dispute/complaint/appeal with a dental plan, learn how to file a 2nd level provider complaint with the California Department of Managed Healthcare.
CDA Business Associate Agreement
An agreement that needs to be read and signed by the dentist when CDA will be handling Protected Health Information obtained from the dentist as we advocated on their behalf with dental benefit plans.
Filing a Complaint with a Dental Plan Regulator
Does a dental plan continuously deny, delay or underpay your claims or repeatedly fail to comply with legal or contractual requirements? Have you exhausted the plan’s internal provider appeal process? If your answer is yes, your next step is to escalate the issue to the dental plan’s regulator.
Payment Dispute Resolution Forms and Processes
There are two levels for appealing payment disputes: first with the plan itself, then with the appropriate regulatory agency. This resource provides a detailed list of contacts and appropriate processes to follow.
The Associate Dentist’s Role in Audits, Complaints and Dental Board or Dental Plan Grievances
When it comes to dental care, patient satisfaction is key, However, despite our best intentions, things may not always go…
Understanding the Claim Appeal Process
California law requires every dental plan to have a formal procedure that providers can use to dispute/challenge actions/decisions made by the plan. Overview of plan legal requirements, steps to appealing claims, filing a payment disputes.