Dear Colleagues,
The ADA belongs to us — its members — and every day across the country dedicated volunteer leaders and our professional team are working hard on your behalf to help you succeed and to advance the health of the public. That’s the ADA’s mission.
I was installed as your president six months ago. No single president in a single term can solve everything — meaningful progress takes time — but in case you’re wondering if the ADA is really making an impact for you, our profession and the public’s health, the answer is a resounding YES, and it would not be possible without your membership.
As I travel the country and listen to volunteer leaders and members alike, one of the biggest pain points shared with me is dental insurance. Here’s what ADA is doing about it:
Protecting clinical autonomy. Let’s start here because as doctors nothing should come between the doctor-patient relationship. There should be no interference with our clinical autonomy when it comes to diagnosing and providing treatment recommendations to our patients. Our ADA Council on Ethics, Bylaws and Judicial Affairs published this white paper on clinical autonomy (PDF) to make our position clear.
Fighting for fairness. We all know that dental plans are not “insurance” compared to medical insurance. Annual patient maximums have not changed for decades, and reimbursement rates have not kept pace with the rate of inflation despite the rising cost of all goods and services. I’m as frustrated as the members I’ve heard from about dental insurance “coverage” and reimbursements that make it difficult for patients to afford necessary major procedures…reimbursements that can also make it difficult to pay dental team members and practice overhead costs, particularly for small, dentist-owned practices that do not have high volume purchasing power for supplies and are not able to spread costs across an entire chain of dental clinics.
So, what is the ADA doing to help balance the scales and achieve fairness for providers and patients alike? These are the dental insurance reform (DIR) issues we are advocating for supercharged by the ADA’s State Public Affairs (SPA) program — funded through your membership dues dollars — that provides grant funding to state dental societies for state-based advocacy. Learn more about all of the ADA’s dental insurance reform efforts at ADA.org/DIR:
Putting power back in the hands of dentists and patients
- Network Leasing: Protecting dentists from being pawned off to different insurance networks without knowledge or consent.
- Virtual Credit Cards: Giving dentists a say in how they get reimbursed for care. Watch this two minute video from me about a victory in model state legislation.
- Assignment of Benefits: Allowing patients to request their insurer pay their dentist directly for care.
- Retroactive Denials: Limiting insurers’ ability to demand repayment of previously-paid claims.
- Prior Authorization Payments: Ensuring that insurers make good on their promise to cover care.
- Non-covered Services: Prohibits insurers from dictating the cost of care they aren’t covering.
- Dental Loss Ratio: Requiring that the majority of patient premiums be spent on patient care.
