Council on Dental Benefits and Care- Third Party Issues

Your FDA’s Council on Dental Benefits and Care and the House of Delegates is working on improving interactions with third party payers. While the following has been approved as FDA policy, only the Florida Legislature can legislate these policies into action. To help accomplish this, we’d like to prioritize which of these three issues are most important to our membership to help our Governmental Action Committee (GAC) in deciding which issues to pursue.

Thank you,

Wendy Churchill-Urrico, DMD
FDA Chair, Council of Dental Benefits and Care

Please Rank the following issues (by clicking on each) from 1-3, 1 being the most important (and needing legislative action first), 3 being the least.

Unranked Choices

Disallowed Clause- Prohibit a dental plan from using disallowed clauses which prohibit a dentist from charging a covered person fora covered procedure not paid for by the benefit plan. Distinguished from an uncovered service, this is a covered service that is neither paid nor chargeable.

Claw back- Shorten the period in which an insurer can recover an overpayment to a provider in Florida from 30 months to 12 months.

Electronic Payments- Ensure third party payers cannot require a provider to accept electronic payment or virtual credit card instead of a physical check. The default payment method would be a physical check, opting into other payment methods.

Ranked Choices

How often do you struggle with obtaining full expected reimbursement for delivered care with patients that have a secondary dental benefit?

Most of the Time

Some of the Time

Never

What other third-party issues affect your practice?