Ill. struggles with state dental plan claims

Delta Dental of Illinois has been unable to quickly reimburse members of the state's dental plans it manages, according to an article in the News-Gazette.

A consequence of the self-funded plans is that the state can only pay out claims when it has the money to do so. Growing pension obligations have impacted the budget across the board, the News-Gazette noted.

Currently, the total owed to dentists and state employees has reached $66 million, the Department of Central Management Services explained. And the Quality Care PPO and Premier plans are 13 weeks behind on claims payments for in-network dentists and 35 weeks for those that are out-of-network, Delta stated in the article.

A law passed in August 2012 permits state employees in Illinois to choose out-of-network dentists. If the dentist accepts the payment of benefits from the employee, he or she can only charge for what the patient's insurance does not cover, the article explained. However, the state is paying 9% interest on debt owed beginning 30 days after the claim is made.

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