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Washington State Dental Association

Third-Party Payer Contracts: Common Questions

The ADA Center for Dental Benefits, Coding and Quality routinely receives the following types of questions from dental offices:

- How can I be part of a network plan when I didn’t sign a contract?
- Why is the plan telling me I have to charge a lower fee to its insured than the fee we mutually agreed upon?
- Can the dental plan withhold future payments to me because of an overpayment or payment made in error?

If you have ever asked yourself these questions, remember when you choose to sign a contract you are entering into a business relationship with the insurance company. These relationships do not need to necessarily be between equal partners. Insurance companies often have the negotiating power. It is important for each dentist to carefully read and understand the contract. Visit ADA.org/dentalplans to learn more.

Questions? Email the ADA Center for Dental Benefits, Coding and Quality at dentalbenefits@ada.org or call (800) 621-8099.

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