Dental Insurance|Dental Practice Advice|Independent Dentist Archives

Should You Drop Delta Dental From Your Practice?

james2026-06-16T00:00:00-04:00

Should I drop out of Delta Dental? Only if you're going to become a genuine student of marketing, otherwise stay put. I withdrew from every Delta plan in my own practice years ago and got a three page hate letter from their president for it. I'd do it again. But I won't pretend it's right for everyone. In some markets Delta owns 80 or 90 percent of the contracted dentists, and that patient flow is real. If you're not prepared to replace those new patients yourself through your own marketing, dropping the plan will hurt you more than the plan does. [...]

Should You Drop Delta Dental From Your Practice?james2026-06-16T00:00:00-04:00

Can You Bill Full Fee After the Insurance Maximum?

james2026-06-16T00:00:00-04:00

Can I bill full fees after a patient hits their insurance maximum? In a lot of states, yes, and you may not know it. Roughly 32 states have passed laws saying that once a patient blows through their annual maximum, every service after that can be billed at your routine full fee instead of the contracted rate. Insurance companies fight this hard with workaround language, and for very large self funded employers the federal ERISA picture muddies things, but for smaller plans the state rulings often hold. The catch is nobody hands you this answer. I've seen dentists ask their own [...]

Can You Bill Full Fee After the Insurance Maximum?james2026-06-16T00:00:00-04:00

PPO Non Covered Services Laws by State

james2026-05-14T00:00:00-04:00

What are non-covered services state laws and how do they help dental practices with PPO contracts? State laws that allow PPO-contracted dental practices to bill out-of-pocket fees at regular rates for services not covered by the patient's plan, including services beyond annual policy maximums. Many states have enacted these laws over the past decade in response to insurance industry practices that previously locked dentists into contracted fees even on uncovered work. Where these laws are in effect, a PPO-participating dentist can continue billing the contracted rate up to the policy maximum, and bill at full fee for any work that exceeds [...]

PPO Non Covered Services Laws by Statejames2026-05-14T00:00:00-04:00

PPO Non Covered Services Laws by State

james2026-05-14T00:00:00-04:00

What are non-covered services state laws and how do they help dental practices with PPO contracts? State laws that allow PPO-contracted dental practices to bill out-of-pocket fees at regular rates for services not covered by the patient's plan, including services beyond annual policy maximums. Many states have enacted these laws over the past decade in response to insurance industry practices that previously locked dentists into contracted fees even on uncovered work. Where these laws are in effect, a PPO-participating dentist can continue billing the contracted rate up to the policy maximum, and bill at full fee for any work that exceeds [...]

PPO Non Covered Services Laws by Statejames2026-05-14T00:00:00-04:00

PPO Non Covered Services Laws by State

james2026-05-14T00:00:00-04:00

What are non-covered services state laws and how do they help dental practices with PPO contracts? State laws that allow PPO-contracted dental practices to bill out-of-pocket fees at regular rates for services not covered by the patient's plan, including services beyond annual policy maximums. Many states have enacted these laws over the past decade in response to insurance industry practices that previously locked dentists into contracted fees even on uncovered work. Where these laws are in effect, a PPO-participating dentist can continue billing the contracted rate up to the policy maximum, and bill at full fee for any work that exceeds [...]

PPO Non Covered Services Laws by Statejames2026-05-14T00:00:00-04:00