Delta Dental Network Update FAQ's
DELTA DENTAL OF MASSACHUSETTS NETWORK BUILD
As you may have heard, Delta Dental of Massachusetts is in the process of building a new network to offer employers more choice in the benefits they offer their members.
Our position as the market leader remains very strong but the future of health care in our home state and throughout the U.S. continues to change rapidly. And we want to make sure we are prepared for whatever the future holds.
We have already received positive feedback from employer groups interested in learning more about this new product. Once our new network is built and products filed, we will be embarking on a comprehensive roll out plan to make sure that you, our valued partner, have all the information you need to help evaluate whether our new plan option meets the needs of you and your employees.
Until that time, feel it is important to provide you with details about our ongoing efforts to offer the widest array of affordable plan options to you, our valued partner.
- Delta Dental of Massachusetts is building a network to offer new products, including a PPO, in the market.
- This new network is completely separate from any existing Delta Dental products/networks you might have and as such has no impact on existing products and networks.
- This new network does not change or impact any existing PPO or Premier provider contracts or fee reimbursements with Delta Dental of Massachusetts.
- Our organization is, and will continue to be a mission‐driven, nonprofit committed to the benefit of the community in service to our clients.
- It is not our role, or intention, to interfere with the relationship between dentist and patient. Under our new plan, members will be able to see any dentist they like; however, their health care benefits and dollars go farther when they find a dental home with a dentist that participates in our network.
Unlike some insurers who focus on one or two market segments, we are uniquely positioned, and continue to have great success, supporting all market segments. But to do that we can't take a one size fits all approach.
Ultimately, this network will provide additional affordable plan options for employers and brokers to consider. We do expect these affordable plans to be very popular, but it will be the employer’s decision whether or not to transition their group to this new product.
Unfortunately, we understand that you may have received inaccurate information and we want to use this opportunity to correct it. While we will be conducting education sessions for you and your clients later this year, below please find some frequently asked questions developed to hopefully address the incorrect information you might be hearing or reading. We will continue to work to keep the market aware of the facts and will continue discussions with our provider partners to make sure that this new network adds value to the marketplace.
FREQUENTLY ASKED QUESTIONS
Q1: Why would an existing Delta Dental provider not join this new network?
A1: Both nationally and locally, we are seeing the growth of PPO products. Our new network contract will include both PPO and Premier reimbursement levels. This means a provider’s reimbursement will be based upon the product a client purchases. While we can’t speak for individual providers, it is possible that some are reluctant to join this network, because it requires them to accept lower reimbursement levels (PPO) for members whose employers purchase that plan instead of a Premier plan.
Q2: Are you forcing providers to join the network?
A2: No we are not forcing providers to join our new network. We value the relationships that we’ve developed with providers over the last 50 years. We have invited all Massachusetts providers to join, including those who have historically hesitated to participate with PPO networks. Some of these providers may want to join our new network, which includes both PPO and Premier reimbursement levels so they do not miss this opportunity. But we certainly urge each provider to make their own, independent choice.
Q3: What are you doing to educate providers?
A3: We have a dedicated team working to educate and recruit providers in Massachusetts. We have been engaging providers through all available channels including: phone, email, mail, in‐person meetings, town hall meetings, webinars etc.
Q4: When do providers need to join?
A4: The deadline for providers to join this new network is Feb. 28, 2017. We extended the deadline to ensure providers had adequate time to consider their options before joining the network. This is important because it gives our brokers and employers a very good understanding of the size and composition of this new network as product strategies are evaluated and discussed.
Q5: Are providers joining this new network?
A5: Yes. Currently about 50 percent of the providers in Massachusetts have signed up to partner with us in this new network.
Q6: Are providers terminating their current contracts with Delta Dental?
A6: No, that is not accurate. Whether or not a provider participates in our new network has no impact on their participation in our existing networks. We have not experienced any change to our historically low network turnover rates since our recruitment effort began.
Q7: When will this new network be available?
A7: We are still building the network but our plan is to begin offering this network to Massachusettsbased employers later this year. Once our new network is built and products filed, we will be embarking on a comprehensive roll out plan to make sure that you have all the information you need to help educate your clients and evaluate whether our new plan options meet the needs of their employees.
Q8: Are employers required to move to a plan offered under this new network?
A8: No. Employers will continue to have the ability to select the plan that best meets the needs of their employees. This new network will provide an affordable option that will be appealing option for employers. As such, we do expect many employers will select this option.
Q9: How will this impact the relationship between employees and their dentist?
A9: Our hope and intention is that our new plan will help strengthen the relationship between dentist and patient. Dentists are the crucial connector for patients to not only provide regular, preventive dental care, but also educate and empower patients about their oral health, healthy habits and the connection to overall health. While it is not our role or intention to dictate treatment, our commitment to improving access to quality dental care remains.
Q10: Is it true that under your new network, dentists won’t be able to refer patients to dentists not participating with DDMA?
A10: While members can choose to see any general or specialist dentist they like, their health care benefits and dollars go farther when they find a dental home with a dentist that participates in our network. Our contract is designed to protect consumers from unexpected out of pocket healthcare costs. The contract encourages high quality, cost effective care in part by calling on providers to refer patients to in‐network specialists.
Q11: Will this change impact the quality of care provided by dentists to members?
A11: No. Today, dentists in Massachusetts already participate in five PPO dental plans on average. We expect providers to always follow the American Dental Association (ADA) Principles of Ethics and Code of Professional Conduct and provide the same high‐quality care to members covered by all insurance options. Any suggestion by dentists that they would alter the quality of the services they provide based on the type of insurance a patient has is in direct conflict with the spirit of the ADA guidelines. Additionally, our contracts include express provisions stating that no part is intended to impact or infringe on a dentists treatment decisions.