Delta Dental of Missouri is reducing reimbursement to providers who participate in its Premier and PPO networks by an average of 7%, but the cuts can exceed 20% in some cases.
The fee reduction went into effect July 1. Under the new reimbursement methodology, Delta Dental of Missouri no longer requires providers to file fees.
Some 60% of dentists in Delta's network got reimbursement cuts of 6% or less, depending on the procedure, said spokeswoman Monica Green.
The move was prompted by increasing competitiveness in the dental insurance marketplace, David Haynes, president and CEO of Delta Dental of Missouri, said in a recent letter sent to Missouri dentists. The company's competitors are offering premiums significantly below its own due to lower fee agreements with their dentist panels, and "we see employers taking notice," he wrote. As a result, clients are demanding lower premiums and greater cost savings from Delta Dental of Missouri for dental benefit plans.
In a separate letter sent to employer groups, Haynes outlined many of the variables influencing Delta Dental of Missouri's decision to reduce provider reimbursement rates. The letter states that if employees continue to see a dentist who participates in its network, they will realize a reduction in out-of-pocket costs. But if they see a dentist who does not participate in Delta's network, they will likely see an increase in out-of-pocket costs.
There are more than 2,500 dentists in Delta's Missouri network.
