ADA: Dental Plan Repricing Targets Out-of-Network Dentists

ADA: Dental Plan Repricing Targets Out-of-Network Dentists

Dental benefits tips from the ADA Center for Professional Success.
Some dental plans may hire repricing companies to negotiate lower fees with non-contracted dentists. These companies offer quicker payment in return for a discounted fee. If you get a notice with an offer like this, you aren’t obligated to accept. If you are interested in giving the discount to get paid faster, you don’t have to accept their first offer. The repricing company may be willing to negotiate the discount with you.

The repricing company has a certain amount of time, usually 10 to 12 days, to get you to accept the discount. If they don’t hear from you in that time, the claim reverts back to the dental plan and is processed as a normal out-of-network submission. If you tell the repricing company that you are not interested, the repricing company notifies the dental plan sooner and the plan can process the out-of-network submission faster, so you may want to respond even if you don’t want to accept the discounted fee.

Plans often hire more than one repricing company to handle a specific claim. You should determine if the offer is for a specific claim or for all future claims from that payer.

Find additional information on dental benefits visit the Center for Professional Success

Don’t see the answers you’re looking for? Get one-on-one assistance with a dental benefits concern from the ADA Third Party Payer Concierge™ at (800) 621-8099 or by email at dentalbenefits@ada.org.
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