Recently, AGD opened dialogue with a senior representative of Delta Dental Plans Association in order to address issues affecting general dentists, the public and the practice of general dentistry.
A key issue of AGD’s communications has been the need for the dental benefits/insurance industry to engage in meaningful and transparent dialogue with participating dentists regarding current financial reimbursement schedules.
AGD’s most recent letter to Delta Dental’s president and chief executive officer expressed concerns about:
- The carrier’s provider loyalty program;
- Its “Pay for Performance” initiative in Washington state;
- Challenges experienced by participating providers seeking to renegotiate fees;
- The insurance industry’s efforts to freeze reimbursement rates throughout the pandemic;
- Delta Dental’s response to the passage of Massachusetts Question 2;
- A request to provide data relating to Delta Dental’s dental loss ratios by state;
- Delta Dental’s planned response in the event that other states attempt to issue similar legislation;
- The practice of some third-party payers to amend fee schedules by decreasing reimbursement rates for commonly performed procedures while simultaneously increasing reimbursement rates for procedures performed less frequently;
- Delta Dental’s positions on key federal legislative issues, specifically:
- Changes made in response to the passage of the Competitive Health Insurance Reform Act (CHIRA); and
- How Delta Dental’s operations and reimbursement schedules might be adjusted with any further expansion of medically necessary dental care in Medicare.
“This effort, like any advocacy campaign, involves many steps and won’t be resolved quickly,” explained AGD President Hans P. Guter, DDS, FAGD. “We are still engaged in the critical first step: educating the carrier about the many challenges you and I face every day in our practices. These conversations take time and require a very nuanced approach. They also require consultation with and involvement by AGD’s external legal counsel to ensure compliance with any applicable antitrust laws.”
AGD remains committed to representing your interests and the interests of your patients. Insurance companies must be responsive to the concerns expressed by their participating providers and the subscribers they serve in their practices every day.
Guter thanks AGD members for partnering with us to ensure that AGD remains the voice of the general dentist. Watch for future updates as they become available.