7/1/2016

ADA sends concerns to Delta Dental
Today’s ADA Morning Huddle reports Dr. Carol Gomez Summerhays, ADA
President, and ADA Executive Director Dr. Kathleen O’Lough sent a letter to
Steven R. Olsen, president and CEO of Delta Dental Plans Association, to
express their “serious concerns and extreme disappointment” over the third-
party payer’s disallow policy.
“By disallowing a service and thus determining definitively that a service does
not need to be performed, third-party payers are effectively interjecting the
plan into the doctor-patient relationship, contravening the professional
judgment of a qualified and duly licensed dental professional,” the Doctors
wrote in their June 20 letter.
“When that determination occurs prior to the performance of the procedure,
the payer places the dentist in the ethical dilemma of declining to perform
the procedure that he or she feels to be necessary or, alternatively, of
performing the procedure without hope of compensation,” the wrote.
This is the second letter the ADA has sent Delta regarding their disallow
policies.
The ADA provides additional information about how it helps with dental
benefit issues at ADA.org/dentalplans