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Delta Dental cuts reimbursement fees for New Jersey and Connecticut dentists

June 18, 2012

By Kelly Soderlund, ADA News staff

Parsippany, N.J.—Dentists in New Jersey and Connecticut are the latest to be affected by cuts in reimbursement fees by Delta Dental.

Delta Dental of New Jersey, a subsidiary of Delta Dental Plans Association that oversees plans in New Jersey and Connecticut, sent a letter to participating dentists May 14 announcing it was reducing fees for many of the procedures it covers.

All procedures were analyzed individually, with a goal of attaining a 4-5 percent claim savings, said Diane Belle, vice president of corporate communications for Delta Dental of New Jersey. Fees for some procedures were lowered, others remained the same and some increased, she said.

Reimbursement fees were reduced between 4 and 13 percent in Idaho last year and in Washington by an average of 15 percent for dentists participating in the premier network and 5 percent for those in the PPO network. The same reason was given for all of the cuts: Delta Dental wants to remain competitive.

“With the economy being the way it is, the employer groups that offer our benefits have a lot of challenges and they’re always looking to lower their costs, including lowering employee benefits,” Ms. Belle said. “We took this action to ensure our benefit plans remain competitive in the marketplace.”

The changes in New Jersey and Connecticut will take effect Jan. 1, 2013.

“It is always unfortunate when reimbursements to dentists are reduced at the same time when the cost to dentists in providing services and patient premiums continue to rise,” said Carol Dingeldey, executive director of the Connecticut State Dental Association.

Arthur Meisel, executive director of the New Jersey Dental Association, echoed the comments made in Connecticut and is also concerned about the decreasing reimbursements paired with increasing costs.

“Based upon anecdotal information, not unexpectedly, dentists in New Jersey are very concerned about reductions in reimbursement levels by any third-party payers,” Mr. Meisel said.

“Since dental practice operating costs and remuneration expectations are unique to each office, if plan reimbursement levels continue to fall and dental practice operating costs continue to escalate, dentists will have to decide on an individual basis whether and to what extent they continue to participate in particular third-party plans.”

Delta Dental of New Jersey set up a phone line and email inbox for dentists to contact with concerns or questions.

There hasn’t been an unusually high number of dentists reaching out but Ms. Belle believes that’s because of the thorough letter the company sent outlining the changes. Beginning May 21, dentists could visit a secure area of Delta’s website to see exactly how their fees would be affected.

The company’s ultimate goal is to continue to provide dental insurance so that more people will visit the dentist, Ms. Belle said.

“We know that people go to the dentist if they have dental insurance so we want to see our groups keep our dental insurance,” Ms. Belle said. “We know it’s good for the dentist when people have dental insurance because people come to them.”