ADA and NADP offer contract tips
- Review the contract and reference documents from the carrier prior to signing. (Contact your state society to access the ADA Contract Analysis Service.)
- Review frequently asked questions in application materials and Web sites prior to joining a dental preferred provider organization, dental health maintenance organization or discount dental plan network.
- Review provider manuals, carrier Web sites and NEA FastLook (www.nea-fast.com/dental_fastlook.html) for carrier鈥檚 claims processing policies.
- After signing a contract, review communications from the carrier and maintain a reference file with the contract, communications and related documents.
- Utilize carriers鈥?resources such as professional relations staff to obtain orientation to policies and procedures for your office staff.
- Use the current version of the ADA Code on Dental Procedures and Nomenclature when submitting procedure codes on claims.
- Notify carriers in writing if you have a change of address, add locations or want to make a change in network participation.
- Follow up with carriers if requested changes are not processed under the time frames and terms of your contract.
- Resubmit denied claims with a request for consultant review if you believe it has been incorrectly denied or disallowed.
- Be aware of potential noncovered procedure discounts to patients.