The Dental Benefits Committee has created to reporting forms to help collect data from members regarding their experiences with dental benefits/insurance issues.
The first form is the Denied Claims Report Form. This form is to be completed by the practice for any claims that get escalated and are denied by the carrier. One form should be completed for each denied claim. The more information you provide, the better the committee will be able to identify trends and create actionable steps to work towards improving dental benefits in Maryland.
The second form, the Dental Benefits Concerns and Complaint Reporting Form, is to be completed for all the “other” dental benefits frustrations and concerns you experience in your practice. Again, each form should be specific for one item/issue. This form will also be reviewed to help identify trends and action items for the committee.
With more than 80% of Maryland’s dental benefit/insurance plans qualifying as ERISA or self-funded and outside the oversight of the Maryland Insurance Administration (MIA), it is critical that the MIA hear from its dental providers all of the complaints and issues you experience across all plans. Only by filing a complaint, even for issues outside of the MIA’s jurisdiction, will they be reported and acknowledged as an issue so that the necessary changes can be made to improve the dental benefit/insurance landscape in Maryland. Currently, in Maryland, only commercial dental benefit/insurance plans are regulated by the State of Maryland. All commercial plans in Maryland will have “MIA” printed on your patient’s insurance card. All other plans qualify as ERISA, self-funded, or some other type of federally regulated plan. To file a complaint with the MIA, visit https://insurance.maryland.gov/Consumer/Pages/FileAComplaint.aspx