California dentists concerned with Delta Dental contract changes: 5 things to know

California dentists and the California Dental Association are concerned with contract changes announced by Delta Dental of California. 

Five things to know:

  1. Delta Dental of California recently sent a notice to providers detailing Premier and PPO providers contract changes that will go into effect Jan. 1, 2023, including fee changes. 
  2. CDA said it followed up with Delta Dental for more information on the changes but was given little detail and told that information was "confidential and proprietary," according to a Sept. 14 news release.
  3. Delta Dental told CDA that the changes were positive and added that decreases to the specialist fees would be less than those it announced in 2020, while schedule fees for general dentists in the PPO network were increased. 
  4. CDA said the payer's representations of the changes do not match member reports that contracted PPO providers will experience fee decreases for many frequently used codes, or that some fee increases could be considered rounding errors. Dentists also reported more burdensome administrative requirements and restrictions that would diminish patient care and devalue benefit plans.  
  5. The CDA said it is taking several actions to support dentists in light of the contract changes, including pressing the payer for an explanation about rate methodology, new administrative burdens and the overall value of Delta Dental benefit plans. The group said it is also evaluating whether legal or legislative action is appropriate.

A Delta Dental spokesperson sent a statement to Becker's in response to the CDA's post:

"We are confident the provider compensation changes will create greater efficiencies and a better overall experience for our providers, and that they will in aggregate raise overall reimbursement for the majority of those providers," the statement said. "As the net change in reimbursement for any individual dentist varies greatly, we encourage providers to contact our Provider Concierge team at 888-742-4099 or by email at cafisupport@delta.org to discuss any questions they may have about the program as it relates to their specific practices."

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