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- ADA Lobbyist Conference (1)
- Adverse actions in dentistry (1)
- Antitrust laws (1)
- Benefit plans (1)
- Billing dispute (1)
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- Competition restraint (1)
- Data bank report eligibility (1)
- Defamation (1)
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- Insurance networks (1)
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- Medicaid reform (1)
- Medicare reform (1)
- Michigan law (1)
- National Practitioner Data Bank (1)
Articles 1 - 5 of 5
Full-Text Articles in Insurance
Dentistry And The Law: Can Dental Plan Ratings Be Defamatory?, Dan Schulte Jd
Dentistry And The Law: Can Dental Plan Ratings Be Defamatory?, Dan Schulte Jd
The Journal of the Michigan Dental Association
This article discusses the legal implications of dental plan ratings for dentists. If a dental plan assigns a rating to dentists and publishes it to patients without providing specific information about the rating's basis or an opportunity for dentists to contest it, legal recourse may be limited. Currently, no statutory law regulates such ratings, leaving dentists potentially vulnerable to defamatory ratings. Under Michigan law, dentists could sue for defamation, but proving the rating's falseness and the resulting loss of patients may be challenging. Federal regulation is suggested to ensure fairness, transparency, and protection for dentists subjected to involuntary ratings.
Negotiating Reimbursement Rates With A Ppo Plan, Dana Moss
Negotiating Reimbursement Rates With A Ppo Plan, Dana Moss
The Journal of the Michigan Dental Association
Dentists often struggle to negotiate reimbursement rates with dental insurance companies. This article discusses the importance of managing reimbursement from benefit plans and highlights the advantages and disadvantages of participating in insurance networks. It provides a step-by-step guide to negotiating insurance allowances effectively, emphasizing the need for preparation, data analysis, and communication skills. The article suggests ways to maintain profitability in practices with a significant PPO patient base. It includes recommendations for keeping fees balanced, choosing negotiation plans, and building relationships with insurance representatives. The emotional aspects of negotiation are also addressed, promoting a respectful and collaborative approach.
News You Need: Reminder: What You Must Know About Antitrust Law, Dan Schulte Jd
News You Need: Reminder: What You Must Know About Antitrust Law, Dan Schulte Jd
The Journal of the Michigan Dental Association
This reminder emphasizes the critical importance for dentists, particularly members of organizations like the Michigan Dental Association, to understand antitrust laws and their implications. The U.S. Justice Department and Federal Trade Commission actively pursue antitrust violations among physicians and dentists. The article outlines key aspects of the Sherman Antitrust Act, emphasizing that joint activities among independent dentists that restrain competition may lead to violations. The concept of joint action and the restraint on competition are explored, with a focus on potential pitfalls, such as price-fixing and group boycotts. Dentists are urged to stay informed to avoid legal consequences.
Dentistry And The Law: Can I Be Reported To The Data Bank In Connection With A Billing Dispute?, Dan Schulte Jd
Dentistry And The Law: Can I Be Reported To The Data Bank In Connection With A Billing Dispute?, Dan Schulte Jd
The Journal of the Michigan Dental Association
This Dentistry and the Law column addresses a dentist's concern about being reported to the National Practitioner Data Bank (NPDB) during a billing dispute. The dentist questions the validity of such a report, considering no issues with treatment quality are raised. The response emphasizes that adverse actions based solely on billing practices may not be reportable to the NPDB. Additionally, it clarifies that a dental plan administrator may not be eligible to make a Data Bank report, offering guidance on informing the plan about rights and potential contestation.
Advocacy Spotlight: Ada Lobbyist Conference Highlights Critical Advocacy Issues, Neema Katibai Jd
Advocacy Spotlight: Ada Lobbyist Conference Highlights Critical Advocacy Issues, Neema Katibai Jd
The Journal of the Michigan Dental Association
The ADA Lobbyist Conference highlighted crucial issues in dentistry, including Medicare reform, teledentistry, workforce concerns, and insurance challenges. State dental associations collaborated on building advocacy partnerships and shared successful grassroots engagement strategies. Medicare reform discussions focused on the ADA's opposition to Plan B inclusion and the impact of constituent outreach. State associations addressed Medicaid reform, emphasizing personal stories to convey the need for change. Teledentistry legislation and insurance company relationships were also key topics. The insights gained will shape the MDA's advocacy strategy for 2022.