Insurance Resources

Insurance Legislation

Insurance Management FAQs
Find answers to frequently asked questions about insurance issues, including coding, billing and other common insurance practices. 

ADA Contract Analysis Service
As a service to PDA members, ADA's Contract Analysis Department will review and comment on insurance contracts. 

Aetna Claim Tips
Helpful Claim Processing Tips for Aetna Particiapting Providers.

Insurance Company Contact Information
This section provides the contact information for the major third party insurers in Pennsylvania. Also provided are links to downloadable claim forms. 

Third Party Complaints
This section is dedicated to receiving member concerns regarding third party insurers. 

Glossary of Insurance Terms
Definitions of terms and types of insurance products. 

Pennsylvania Department of Insurance
Here you can find contact information for the Department of Insurance's three regional offices and a complaint form should you feel the filing of a complaint is warranted. 

Insurance Claim Processing Manual (PDF file)

National Provider Identifier
Dentists can apply for a National Provider Identifier (NPI), which was mandated by HIPAA and will replace other identification numbers issued by health plans and will be required for electronic transactions. 

Enrollment Requirements for Writing Prescriptions for Medicare Part D Drugs (PDF file)
Federal government issues new provider enrollment requirements for writing prescriptions for Medicare Part D Drugs. Dentists who write these prescriptions must decide whether or not to opt in as a Medicare provider. 

Your Advocate: Taking the Lead on Insurance Reforms (PDF file)

United Concordia Meeting Report
PDA Meets with United Concordia (UC) to discuss claim rejections and processing policies. Representatives from PDA indicated that they are personally experiencing claim rejections for restorations, crowns and S&RP and they have heard similar complaints from many of their colleagues.

PDA Takes United Concordia Dental to PA Insurance Commissioner
 In response to United Concordia Dental's (UCCI) recent decision to reduce fees, PDA is aggressively protecting our members’ best interests by immediately pursuing a state investigation of this highly questionable action.