Yesterday evening, Governor Cuomo issued a press release sharing guidance from the Department of Financial Services (DFS) to insurance providers. DFS guidance is not directed to health care providers.
On behalf of our members, NYSDA has written to the 15 major dental insurance companies in New York State advocating for the direct reimbursement of PPE expenses or for increased reimbursement rates to account for new PPE costs for in-network providers. As a result of the letter campaign, we have forged new relationships, and some companies have allowed dentists to bill additional for PPE.
The American Dental Association (ADA) has reported some movement in its national advocacy effort, as several dental plans across the country are offering incentives to offset PPE costs. These include reimbursement for PPE expenses, grants to offset PPE costs, or allowing their in-network providers to bill patients.
The ADA strongly encourages dental offices to disclose any additional fees upfront to patients and to document these charges in the patient record. The ADA has recommended that dental benefit carriers either adjust the maximum allowable fees for all procedures to cover the increased costs of PPE or allow an additional standard fee per date of service per patient.
Some insurance carriers have support programs for additional PPE expenses. Information in the ADA’s COVID-19 Coding and Billing Interim Guidance: PPE tracks which payers instituted the additional support program for PPE.
NYSDA is launching initiatives to address the burdensome cost of dental PPE directly with both the governor and with DFS. NYSDA does not consider this Circular Letter to adequately address the underlying issue in any meaningful or helpful way.