INSURANCE CONNECTION
Update – PDA’s Discussion with Insurance Commissioner About United Concordia Dental
On August 15, PDA president Dr. Herb
Ray, along with PDA legal counsel Tom
Weber, our CEO Camille Kostelac-Cherry
and Dr. Dave Larson, PDA’s representative
on ADA’s Council on Dental Benefits
Programs, had a lengthy meeting with the
general counsel of the PA Department
of Insurance and her staff to discuss the
proposed reimbursement rate reduction
by UCCI and the use of this reduction to
force participants to leave the network.
Dr. Ray highlighted how every cost
associated with providing quality dental
care has increased over time, and yet,
despite premium charges increasing over
time, reimbursements have been
stagnant and now potentially decreasing.
Dr. Ray outlined the negative impact on
patient care, access issues, public health
consequences and dentist financials
caused by the dental benefit providers.
Dr. Larson provided national statistics
showing Pennsylvania ranking near the
bottom of retention of dentists.
Although it was not the focus of the
meeting, the group also discussed
assignment of benefits. General Counsel,
as a consumer of dental services,
appeared to appreciate how the absence
of assignment of benefits could be a
barrier to care.
The Insurance Department
representatives understood the issues
discussed and encouraged PDA to reach
out to the Department of Human Services,
as well as the Department of Health to
see what influence they could have in
leveling the playing field.
Because the Insurance Department
deals specifically with patient complaints,
patient data is helpful to the department.
Should anyone have information related
to patient complaints resulting from the
reimbursement reduction or the lack of
assignment of benefits, please encourage
your patients to contact the Department
of Insurance at http://www.insurance.
pa.gov/Consumers/File%20a%20
Complaint/Pages/default.aspx
The department also encouraged PDA’s
effort to explore possible legislative
remedies.
We asked the department to examine
what information they have available as
to the increasing consumer cost of dental
benefits. PDA will follow up on this
request and continue to pursue every
avenue available to advocate on behalf
of our members and the public. Stay
tuned to the PDA website for additional
information and updates as your
leadership represents you and your
interests in this matter.
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