Dental Professionals

Provider Insurance Contracts


Situation Overview

The Wisconsin Dental Association has learned that many dentists recently received a communication from Delta Dental of Wisconsin (DDWI) regarding that insurer’s intent to reduce reimbursements to Premier Network and/or PPO providers in several geographic areas around our state. (We are also aware that some dentists have received letters stating they are not affected by this change.)

WDA disagrees that DDWI needs to reduce any reimbursements to remain competitive in the marketplace, an argument shared by company representatives  in a July 2018 phone call with association staff and president-elect.

WDA also objects strongly to DDWI’s recent actions and believes they pose a serious risk to access to care for consumers, as well as the businesses of member dentists.

Because of Federal anti-trust laws (see right column), the WDA is unable to provide legal advice regarding acceptance of the DDWI or any contract or amendment. Participation in any benefits program is an individual dental practice business decision (see July/August 2016 WDA Journal President’s Message).

The WDA Board has scheduled a special meeting in early August 2018 to discuss all options available to the association to act on behalf of its members. We understand that members hope for and expect swift action.  However, it is important for the officers and trustees to have full, frank discussions about any potential actions the association may take and the consequences these actions may have.

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Wisconsin Office of the Commissioner of Insurance

In addition, WDA leadership and staff will meet with the Wisconsin Office of the Commissioner of Insurance (OCI) in the coming weeks.

Dentists who are being negatively affected by these rate reductions are welcome to contact the OCI. Any and all complaints filed are fully investigated by OCI, which has already received a significant number of contacts on this issue:

  • File complaint online
  • Download complaint form and mail to: Wisconsin Office of the Commissioner of Insurance, P.O. Box 7873, Madison, WI 53707-7873
  • Fax to: 608-264-8115
  • Complaint Phone Numbers: 608-266-0103 (Madison) or 1-800-236-8517 (statewide, toll-free)

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Delta Dental of Wisconsin Contact Information

Direct all questions about latest reimbursement changes to Delta Dental of Wisconsin’s Professional Services Department at 800-836-0490 or pscoordinators@deltadentalwi.com.

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Insurance Contract Best Practices

The WDA also urges member dentists to:

  • Be aware of all contract renewal dates.
  • Carefully review contents of all provider agreements and amendments before signing.
  • When considering signing on as a new provider, utilize the American Dental Association’s free Contract Analysis Service. This service is available to WDA members when submitted through Dental Practice and Government Relations Associate Erika Valadez (evaladez@wda.org) in the WDA Legislative Office.

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Member Communications on DDWI Situation

Anti-trust blog post (Aug. 2, 2018)

WDA exploring options to amended reimbursements (July 9, 2018)

WDA Journal January/February 2018 issue: WDA helps secure contract changes

WDA Journal January/February 2018 issue: Devil is in the contracts

Blog post (Jan. 18, 2018)

New Update: Company response to contract (Dec. 18, 2017)

Update: Recent contract amendments (Dec. 15, 2017)

WDA members advised to carefully read recent contract amendments  (Nov. 20, 2017)

Dental insurance or dental assistance?, President’s Message, WDA Journal July/August 2016

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Dental Professionals

WDA