The California Dental Association filed a legal action in late December 2022 against Delta Dental of California challenging Delta’s 2023 adjustments to Premier and PPO provider agreements in California.
The “swift and severe” adjustments, effective Jan. 1, include significant fee reductions for many California dentists, increased administrative burdens and diminished value of benefit plans, according to the complaint.
CDA alleges in the Superior Court of California that the board of directors of Delta Dental violated its fiduciary duties by, among other things, failing to conduct appropriate analysis of the need for and impact of the contract changes to Delta Dental’s provider networks and patients.
Least of the problems facing dentists who deal with Delta Dental. Delta systematically denies dental claims and plays games until the dentist gives up and swallows the bill. The dentist will call the patient the patient then calls Delta to see what is going on. Delta will then lie to the subscriber implying the dentist was already paid or did not submit xrays or some other nonsense reason for not paying something as simple as a D1110 prophy. Out of 100 Delta Dental claims generally all will receive a denial or a reduction, and generally can take months of chasing to get paid.