February 06, 2012
Once again, Delta Dental punishes dentists and patients for going to an out of network provider ("Illinois Delays Dental Claims," Nov. 7 ADA News). The questions are: (1) Is this legal? (2) Is Delta Dental a dental maintenance organization or preferred dentist program?
This article clearly states that in order to save the state money, it delays payment to out of network providers by 200 days compared to in network providers at 91 days. Finally, a Delta spokesperson admits this discrimination!
Also other Delta plans, possibly this one, refuse to send payment directly to the out of network dentist. I'm sure that this too is another way to "save" money for the state (or Delta Dental). This "is meant to steer dentists toward participating in the Delta Dental PPO and Delta Dental Premier networks," as stated in the article.
Clearly this article states Delta Dental's stance on payment of claims and the relationship between doctor, patient and insurance company. Why is this legal? I believe that by using these tactics, Delta Dental is interfering with the patients' right to choose their dentists. If given a choice, most patients will not sign up for a DMO plan.
What if all other PDP insurance plans started acting like Delta Dental? I believe that this discrimination between who to pay and when to pay is unethical and illegal.
Thomas Piazza, D.D.S.