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Delta Dental to cut payments to NJ, Conn. dentists
By Donna Domino, Features Editor

June 1, 2012 -- New Jersey and Connecticut are the latest states to be hit with reductions in reimbursements by Delta Dental within the last year.

Delta Dental announced it will to cut payments to New Jersey and Connecticut dentists by 4% to 5% in 2013. Delta cut reimbursement rates for Idaho and Washington dentists last year.

The cuts will take effect January 1, 2013, for dentists in Delta Dental's Premier fee-for-service network and will be based on ZIP codes, according to letters sent to New Jersey and Connecticut dentists.

The cuts will enable Delta Dental to remain competitive against large insurance companies such as Horizon Blue Cross Blue Shield of New Jersey, Anthem Blue Cross Blue Shield of Connecticut, Cigna, Metropolitan Life, and Aetna, according to spokeswoman Diane Belle. Lower reimbursements will result in overall reductions in claim payments, which the company says it will pass on to its insureds, Belle said.

"We're hoping to pass on the savings to our group in the form of lower rates," Belle told DrBicuspid.com. "Our employers are facing a lot of challenges, and employee benefits are places where they're looking to cut. We know that people are more likely to visit the dentist if they have dental insurance, and we want them to keep the insurance so we have to make it attractive for them to keep it."

The changes will affect 5,846 New Jersey dentists and 2,175 Connecticut dentists. Delta Dental's Premier Network is the largest network in the U.S.

"Connecticut dentists are aware of the reimbursement rate cuts that Delta Dental of New Jersey feels are necessary and will be implementing early next year. It is always unfortunate when reimbursements to dentists are reduced at the same time when the cost to dentists in providing services continue to rise," Carol Dingeldey, director of the Connecticut State Dental Association, stated in an email to DrBicuspid.com.

The New Jersey Dental Association declined to comment.

Last November, Delta Dental cut rates between 4% to 13% for Idaho dentists in the company's preferred provider organization (PPO) dental plans, which affected all 825 dentists in the state, according to the Idaho State Dental Association (ISDA).

The reductions affected all Idaho dentists, even those who don't contract with Delta Dental in the PPO plan, because they also reduced the allowable rates for dentists who don't have contracts with Delta, said ISDA President Gregory Bengston, DDS.

And last June, the Washington Dental Service (WDS) -- a member of the Delta Dental Plans Association -- slashed reimbursements by 15%. The reduction applied across the board to approximately 4,000 dentists in Delta Dental's Premier fee-for-service network.

Last month, a controversy erupted after WDS CEO James Dwyer said that dentists should work more to make up for the reimbursement cuts. Dwyer, who earns $1.2 million a year, made the comments during a television interview in which he suggested that dentists could make up lost revenue by working more five days a week instead of three or four days.

The Washington State Dental Association called Dwyer's comments "outrageous and disrespectful."

Dwyer later offered a qualified apology and said his comments were taken out of context.

Delta Dental to cut payments to Idaho dentists, September 27, 2011

Washington Dental Service to cut reimbursement fees 15%, April 26, 2011


Copyright © 2012 DrBicuspid.com

Last Updated hh 5/31/2012 4:15:54 PM

7 comments so far ...
6/4/2012 12:18:53 PM
novodont
Don't count on Delta Dental to reduce premiums with the reimbursement cuts!  I bought a Delta plan for my family and employees with a $2000 annual maximum a few years ago.  WDS cut our reimbursements 15% in July, but there was no change in the premium when our renewal came up in December.   We dropped our Delta coverage over this issue. 
6/4/2012 12:51:04 PM
glenp
Please let's not hear whining from providers outraged over this.  A patient is treated for their needs, not by their wallet.  Dental coverages are merely a METHOD OF PAYMENT by the patient.  Patients are responsible for paying their own way.
6/4/2012 1:44:14 PM
fredo
"By Dentists, for Dentists"
"Not for profit"
Delta Dental was the insurance industry's Trojan Horse in infiltrating Dentistry.  Let's face it, it was a smart way to do it and they won.  No whining...you're stuck with them now.  They control your market and your price, but bear no responsibility for your costs or your liability -  and their coverage limits actually provide patients with many reasons NOT to have treatment.  They're not YOUR patients anymore, Doctor...they're DELTA'S patients; accept this undeniable fact and get over it.
 
6/4/2012 3:46:38 PM
DENTSURG
CT Dentists: Options are clear.
  1. Withdraw from Delta and cancel your participating provider agreement,
  2. Absorb the reduced payments (and increased payment restrictions) and do nothing,
  3. Unbundle ALL procedures that have ADA codes and claim them when service rendered (i.e. followup care, exams with palliative treatment, pulp caps),
  4. Do MORE procedures within the parameters of the dental plan and the ethics and need of patient care,
  5. ENCOURAGE full utilization of the plan by patient-members.
 
6/6/2012 5:58:29 PM
risklife
fredo - you are so right. Delta was a scam from the beginning. Check out the CEO of Wash State Delta, Jim Dwyer; find the TV interview where he says that if the dentists would work more than 3 or 4 days per week then the cuts he instituted would be okay. He makes 1.2M!!!
Anyone who thinks that participating in these plans will make them a success is a fool. They take over your practice, control your income and decide how you treat. Sorry Dentsurg - your plan as it is can't work, the insurance companies are way ahead of you - re: unbundling, and such- the only way is to quit partciipating- I did in 1989; those people who trust you and are coming to you out of respect for you as a person and a dentist will stay- your job is to create financial systems so that you can perform the proper treatment. Those that come to you because you are in the book will leave - they always leave for the next bargain. Please don't believe this stuff about not affording the dentistry without insurance. Look out at the cars they drive, the clothes they wear, and the trips they take. That they want - that they can afford. We should grow up and build our practices on trust and excellence, not because we take their insurance.
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