Insurance Commons^™

Mda Insurance - Online Open Enrollment Now Available For Mda Health Plan, Craig Start

The Journal of the Michigan Dental Association

Craig Start, President of MDA Insurance, discusses health insurance planning for dental practices and families, introducing a new secure online open enrollment process through Employee Navigator for the MDA Health Plan. Running through October and November 2026, this online portal coordinates plan sponsors and employees to adjust coverage and add dependents. The article highlights other critical 2027 health coverage enrollment timelines, including individual marketplace plans and Medicare supplement choices, and emphasizes the personalized, cost-free advisory and claims advocacy services provided by MDA Insurance agents to support informed decision-making.

When Dentists Spoke Up, The Law Changed, Timothy Rath

The Journal of the Michigan Dental Association

This article details how grassroots member advocacy led to the passage of Michigan Senate Bill 105. Championed by the Michigan Dental Association, the law requires insurers to offer at least one fee-free payment method for dental reimbursements, protecting practices from being forced to pay transaction fees of 3% to 5% to access virtual credit card payments. Once a dentist opts out under the new law, insurers must maintain the alternative payment method. This legislative victory highlights the power of organized dentistry in relieving the administrative and financial burdens faced by individual practitioners amid rising operational overhead costs.

Mda Insurance: Voluntary Benefits Help With Employee Recruitment, Satisfaction, Retention, Craig Start

The Journal of the Michigan Dental Association

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This article discusses how voluntary employee benefits can strengthen recruitment, retention, and employee satisfaction in dental practices. Topics include health insurance, disability coverage, life insurance, critical illness protection, accident insurance, vision plans, and cafeteria plans. The author explains how benefit offerings can improve workplace competitiveness while helping employees manage financial risks and healthcare costs.

Mda Insurance: Review Your Health Insurance Plan For 2026 Open Enrollment, Craig Start

The Journal of the Michigan Dental Association

MDA Insurance President Craig Start urges members to review their health insurance ahead of the 2026 open enrollment period. Open enrollment is the annual window to change carriers, elect new plans, or add dependents. Dates vary by plan: the MDA Health Plan runs from October 1–November 15, while Medicare Supplements/Advantage/Medigap Plans run from October 15–December 7. Members must assess anticipated health changes, potential costly prescriptions, and financial comfort with higher deductibles versus higher premiums. MDA Insurance assists members in making informed decisions and acts as the member's agent of record to help resolve claims and issues throughout the year.

Extension For Insurance And Patient Conflict Prevention, Richard Sherman

SFDDA Newsletter

In 1891, G.V. Black presented the idea of “Extension for Prevention.” The concept was to complete a restoration so that the margins and occlusal grooves were treated in such a way as to “prevent” further carious involvement. Hopefully his technique prevented millions of teeth from needing retreatment. However, dealing with humans and sometimes their “lack” of proper oral hygiene habits, new carious lesions do appear on the same teeth in the same or different areas, This article examines the conflict occurring between insurance coverage and the patient when experiencing a new caries on a previously restored tooth.

The New Professional: Demystifying Dental Insurance For The New Professional, Amrita Patel D.D.S.

The Journal of the Michigan Dental Association

This comprehensive guide explains dental insurance complexities for new associates and practice owners. The author distinguishes dental insurance from medical insurance, noting annual benefit caps of $1,000-$2,000 versus unlimited medical coverage. Four main plan types are detailed: PPO plans (most common, flexible), HMO plans (lower costs, network restrictions), Indemnity plans (no network limits, higher costs), and Discount plans (membership programs, not insurance). Key business considerations include in-network versus out-of-network decisions, with in-network providing patient attraction but reduced reimbursements, while out-of-network allows fee control but limits patient base. The article addresses practical challenges including write-offs (difference between standard fees and insurance …

Mda At Your Service: One Way To Free Your Practice From Insurance Plan Restrictions, Rachel Sinacola D.D.S.

The Journal of the Michigan Dental Association

This Q&A-style article provides practical answers to common member questions. Topics include managing in-office dental plans (via Quality Dental Plan), evaluating associate contracts, showcasing MDA membership, handling radiography training course transfers, and understanding patient record retention requirements. The article encourages using MDA-endorsed resources and legal guidance to enhance practice efficiency and compliance.

Mda Services: These Three Companies Can Help You Establish Your Own Practice, Reva Darling

The Journal of the Michigan Dental Association

Starting or acquiring a dental practice is a significant but rewarding endeavor. The Michigan Dental Association (MDA) endorses three key companies to assist dentists in this process: Bank of America Practice Solutions for financing, Bridge Commercial Realty for real estate guidance, and PPO Negotiation Solutions for optimizing insurance participation. These vetted partners offer essential support in securing loans, selecting practice locations, negotiating leases, and managing insurance networks, ensuring dentists establish financially sound and sustainable practices.

Mda Insurance: Simple Tips To Improve Your Property’S Insurability, Jeff Spindler Mda Ifg

The Journal of the Michigan Dental Association

The article discusses the importance of proactive home maintenance in maintaining property insurability and managing insurance premiums. It highlights how insurance companies are responding to increased claims from weather events, particularly wind and hail damage in Michigan. The author emphasizes that while insurance covers unexpected damage, it doesn't cover normal wear and tear or deferred maintenance. The piece provides six practical tips for homeowners to reduce risk and prevent insurance claims, ultimately helping to stabilize premium rates.

January 15, 2025 — Welcome Letter To Members Of The 119th Congress, American Dental Association

Advocacy in Action letters

No abstract provided.

Dentistry And The Law: The Difference Between ‘Non-Covered’ Vs. ‘Disallowed’ Services, Daniel Schulte Jd

The Journal of the Michigan Dental Association

The article clarifies the distinction between "non-covered" and "disallowed" services in dental plan audits. Non-covered services are not included in the patient’s dental plan, often due to plan limitations, while disallowed services are covered but deemed non-payable due to issues like claim deficiencies or lack of documentation. Dentists must review their contracts to understand obligations regarding non-covered services and ensure compliance with HIPAA for patient-paid services. For disallowed services, contesting decisions may be possible depending on the agreement with the dental plan.

Advocacy Spotlight: Understanding The Mda's Role With Dental Insurance Reimbursement Rates, Daniel Miller D.D.S.

The Journal of the Michigan Dental Association

The Michigan Dental Association (MDA) is dedicated to advocating for members and advancing the dental profession. While federal laws prohibit the MDA from negotiating reimbursement rates with dental insurers, it provides significant support through education, advocacy, and resources.

Key initiatives include enhancing transparency in network leasing, endorsing PPO Negotiation Solutions to help practices optimize contracts, and offering educational programs on billing and coding. The MDA also facilitates peer networking and equips dentists with tools to navigate insurance challenges effectively.

Looking ahead, the MDA remains committed to empowering members through advocacy, guiding future dentists on contract literacy, and fostering a resilient …

Nys Workers' Compensation & No-Fault Cases: The Good, The Bad, And The Ugly, John Sorrentino D.M.D.

The New York State Dental Journal

Agreeing to do a workers' compensation or no-fault case can be a great practice builder and have a powerful and positive impact on the lives of people who have been devastated by a workplace or automobile accident. Yet, many practitioners hesitate or refuse to do these kinds of cases for a variety of reasons. Often, you are dealing with insurance companies that are unfamiliar with dental claims. Perhaps because these claims don’t crop up often, you are not familiar with the process, or you have heard stories of poor, or even no reimbursement.

Staff Matters: Assessing Health Benefits For Lgbtq+ Employees, Jodi Schafer Sphr, Shrm-Scp

The Journal of the Michigan Dental Association

To support LGBTQ+ employees, understand your health benefits by asking key questions about domestic partner coverage, mental health benefits, transgender healthcare, IVF, and surrogacy coverage, and identifying LGBTQ+-friendly providers. Regularly check in with staff to ensure benefits meet their needs and consider making changes if necessary. Proactively share benefit information throughout the year to enhance employee recruitment, retention, and engagement.

The Back Page Commentary: Care For Special Needs Patients: We Must Do Better, Craig C. Spangler Dds, Fscda

The Journal of the Michigan Dental Association

Despite strides in providing resources for neurodivergent and geriatric patients, access to suitable dental care remains a challenge. A survey revealed finding capable dentists as the primary barrier to care for special needs individuals. Transitioning from pediatric to adult care lacks continuity, highlighting gaps in predoctoral dental education. Challenges include inadequate training, limited opportunities for continuing education, and reimbursement issues. Collaboration between medical and dental leaders is crucial for addressing these pressing issues and ensuring equitable access to care.

New Dentists’ Most-Asked Legal Questions, Dan Schulte Jd

The Journal of the Michigan Dental Association

This feature addresses new dentists' most frequently asked legal questions, offering concise answers to guide them. Topics include licensing requirements, dental record maintenance, accommodations for hearing-impaired and non-English proficient patients, the enforceability of covenants not to compete, the necessity of written employment agreements, responding to bad dental work, reporting suspected abuse, prescribing drugs to friends and family, contract terms with dental plans, and handling suspected employee theft. The article emphasizes the importance of understanding legal aspects to navigate a dental career successfully.

Staff Matters: How Can We Be More Creative With Our Benefits?, Jodi Schafer Sphr, Shrm-Scp

The Journal of the Michigan Dental Association

As open enrollment for health benefits approaches, this column discusses creative and cost-effective benefit offerings to attract and retain employees. The focus is on innovative benefits beyond traditional health, life insurance, and retirement plans. Suggestions include pet insurance, paid volunteer time, lunch and learn sessions, and flexible scheduling to accommodate employees' needs, particularly working parents and those with caregiving responsibilities. The importance of seeking employee input in benefit planning is emphasized for discovering practical, employee-desired options.

Doj Withdraws Healthcare Antitrust Protections, Lance Plunkett Jd, Llm

The New York State Dental Journal

DOJ has withdrawn longstanding antitrust guidance that provided safe harbors for specific conduct in the healthcare marketplace.

Improving Access For Children And Adults With Disabilities Through Enhanced Commercial Benefits, Holli Seabury Edd, Jeff Johnston Dds, Ms

The Journal of the Michigan Dental Association

This article explores the critical issue of accessibility to oral healthcare for people with disabilities in the United States. Delta Dental of Michigan, Ohio, and Indiana has taken a step by providing enhanced commercial benefits to children and adults with disabilities. The article delves into the challenges faced by this vulnerable population, including cost barriers and transition issues, and discusses how expanded benefits and coding, along with special dental care provisions, aim to improve access. It emphasizes the importance of proper benefits verification and presents a case study illustrating the utilization of these benefits. The article highlights the need for …

J Mich Dent Assoc March 2023

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members across the state. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on canceling provider agreements with dental plans.
• A clinical update on when and how to use Silver Diamine Fluoride to manage carious lesions
• News from Delta Dental on efforts to address access to care for disabled individuals through enhanced commercial dental benefits.
• The value of focused counsel from a …

Is It Time To Rip Up Your Contract? Navigating Dental Plan Participation, Stephanie Smith

The Journal of the Michigan Dental Association

This article explores the importance of dental practice management and the potential benefits of breaking away from insurance company participation agreements. The author, a practice management coach, emphasizes the role of data analysis, effective communication, and patient-centered strategies in achieving practice independence. Key areas of focus include assessing practice performance, understanding insurance reimbursement rates, and enhancing accounts receivable processes. The article provides insights into strategically transitioning to non-participation with insurance plans while preserving patient relationships. It highlights the significance of transparent communication, staff training, and timing when considering such a transition.

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

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

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.

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.

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.

J Mich Dent Assoc October 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story, “Welcoming Colleagues from Different Practice Models”.
• A feature article from the Journal’s DEI series, “Diversity, Equity, and Inclusion: Perspectives from an LGBTQ Dentist”.
• A feature article, “Congratulations, 2021 MDA Life Members!”.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff Matters, and component news. …

J Mich Dent Assoc September 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story with “Reports from the Dental School Deans”, Dr. Mert Aksu and Dr. Laurie McCauley.
• A feature article from the Journal’s DEI series, “Building a Culturally Competent Practice”.
• A feature article, “Disability Insurance: 10 Things You Need to Know”.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and …

J Mich Dent Assoc April 2021

The Journal of the Michigan Dental Association

In the April 2021 issue of the Journal of the Michigan Dental Association, we offer a comprehensive range of original feature content showcasing the latest developments in dental practice and knowledge, including:

1. AI in Dental Care Delivery: Explore the groundbreaking role of Artificial Intelligence (AI) and Machine Learning in dental care, revolutionizing efficiency, safety, care outcomes, and treatment planning consistency.
2. AI in Dental Claims Processing: Discover how AI is employed by third-party payers to streamline dental claims processing, resulting in cost containment and the proactive identification of potential fraud, waste, and abuse.
3. Evidence-Based Dentistry: As part of …

J Mich Dent Assoc December 2020

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on “The Dentist’s Role in Recognizing Sleep-Related Breathing Disorders: A Two-Part Series”.
• The “2020 Author/Title Index to the Journal of the Michigan Dental Association”.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff Matters, and component news.

This issue also includes three articles reprinted …