Page 13 - Bulletin Vol 29 No 2 - May. - Aug. 2024 FINAL

In Our Society | Member Benefits

Problem with an Insurance Company? Members Have Help!

Doing dentistry is tough enough, but the business side can be even more onerous, especially when it
comes to dealing with insurance companies. From claim rejections to delay tactics to code changes, it can
all be a time-consuming challenge. But as a member, you don’t have to go it alone!

The ADA has an entire section of their website dedicated to helping you solve dental insurance issues. Go
to ADA.org/dentalinsurance to find an array of articles to help improve the insurance side of your practice.
There is also the ADA Credentialing Service powered by CAQH that lets you fill out one form to update
your credentials with multiple insurers. But perhaps the best service of all is the ADA Third Party
Payer Concierge. With this service you can call or email a live person to directly help you with your insur-
ance issue. You can reach the Concierge from 8:30 a.m. to 5:00 p.m. Central Time (9:30 a.m. to 6:00 p.m.
Eastern time) Monday through Friday. Phone: 800-621-8099. You can also email them at:
dentalbenefits@ada.org All this is free and available to members only!

Many dentists cite dental insurance as the source of one of their greatest frustrations. This service pro-
vides much-needed assistance for dentists with insurance-related questions and concerns that they cannot
find elsewhere. Even though many dentists’ issues come down to contractual obligations, the ADA can pro-
vide education on the nuances of doing business with dental insurance companies and how to empower
themselves to make decisions that are best for their patients and their practices. In addition, they will re-
view a participating provider agreement before you sign it, at no cost to the member.

Another issue, coordination of benefits, is a constant source of confusion for many dental offices. The Con-
cierge will be able to help answer questions and address concerns regarding COB. Another common con-
cern from dental offices involves claim denials. While the Concierge may not be able to get a claim paid for
you, it can help with the appeals process. Lastly, dentists have reported concerns with poorly written ex-
planation of benefits statements and the Concierge can also help dentists with EOB language questions as
well. Just another member benefit that you might not be aware of.

But if you are still having issues in spite
of this assistance, you do have another
recourse. You can file a complaint with
the Insurance Department of New York
State, which is within the Department of
Financial Services. To do so, go online
to: https://www.dfs.ny.gov/complaint .
If this is your first time there, you will
have to create an account. Once you do
that, then scroll down to Healthcare
Provider Complaints and click on the
DFS Portal button. Then click on Request
Apps and scroll down and click on
Provider Complaint Forms. Then just
follow the prompts and fill out the form.
You’ll need to complete and submit it
withing 30 minutes of starting it, so have
all your information ready.

Nassau County Dental Society ⬧ (516) 227-1112 | 13