Have You Done an Annual Review of Your Participating Provider Agreements?

Read on for an important reminder from the ADA about reviewing your participating provider agreements and for valuable members-only dental benefits resource​s.

Have You Done an Annual Review of Your Participating Provider Agreements?

It’s that time of year: leaves are falling, temperatures are dropping and fall is upon us. This is a good time for you to review all of your signed dentist participation agreements. If you don’t have copies, contact the dental plans to get them so you can conduct reviews annually.

Pay special attention to clauses that impact your bottom line (non-billable and non-covered services, most favored nation and affiliated carrier) and national processing policies (bundling, downcoding and least expensive alternative treatment clauses) in your review.

You should read and evaluate participating provider agreements carefully before signing to decide if the plan is a good business decision for your practice. This webinar explains why these contracts are so important.

You can also send unsigned agreements to the ADA Contract Analysis Service for review. While we won’t give specific legal advice, we’ll give you a plain-language analysis of the contract so you can understand its terms and decide whether it’s a good fit for you. There’s no cost to you if you go through your state or local dental society.

Find answers to frequently asked dental benefits questions at the Center for Professional Success. Or get one-on-one help with dental benefits concerns from the ADA Third Party Payer Concierge™ at 800-621-8099 or by email at dentalbenefits@ada.org.