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New Tricare Dental Provider Calls Complaints 'Typical'

U.S. Coast Guard photo/Petty Officer 3rd Class Barry Bena
U.S. Coast Guard photo/Petty Officer 3rd Class Barry Bena

A month into the changeover, Tricare's new dental insurer, United Concordia, says it's meeting contract requirements and that user complaints about lack of access and dentists' about low reimbursement rates are a "typical" part of any change.

United Concordia took over the $2.9 billion contract from MetLife on May 1, ushering in lower premiums and better coverage for active-duty families, Guardsmen and reservists, and their families who buy into the plan.

But the changeover also brought a parade of criticism from dentists who left the network, saying payment rates are unsustainable, and patients who lost their provider as a result. United Concordia last held the Tricare dental program (TDP) contract in 2012.

The new Tricare dental contract does not affect military retirees.

"Provider concerns are an expected and typical part of any contractor change," Sharon Duke, a spokesperson for United Concordia, said in a statement. "This is no different from when the contract transitioned five years ago. In fact, the [negative] social media and other communications regarding the transition are significantly less than was experienced in 2012."

Tricare's top officials said they are keeping a close eye on the new contract and patient feedback.

"I have asked our team to ensure we are responding to patient queries in the timeliest manner possible," Navy Adm. Raquel Bono, who heads the Defense Health Agency, which oversees Tricare, said in a statement to Military.com.

"We are reviewing contractor performance on a daily basis, and I will be meeting with veteran and beneficiary organizations in the next few weeks to give them a comprehensive update on the status of the contractor's performance in all of our military communities," she said.

"United Concordia is offering a network of general dentists that meets contractual requirements," she added. "However, this is only a first step, as we have a number of metrics we use to assess whether the network meets the needs of our beneficiaries."

Poll: Did Your Tricare Dentist Drop You?

Military family advocates are wary of the new program. They said they've heard more complaints from users than ever before, as well as feedback from providers themselves, a group that does not typically contact military family advocates.

"It is important to note that we are not saying these complaints are universal -- certain areas are experiencing more network churn than others," Karen Ruedisueli, a government relations deputy director at the National Military Family Association, wrote in an article posted to the organization's website late last month.

"However, the range and intensity of the outcry we've heard from you seems more pronounced than we have experienced with past contract transitions," she wrote. "It seems that the value of the Tricare Dental Program benefit has been diminished for a pretty significant segment of military families."

She added, "Specifically for families who have to switch dentists, families who have to travel further for dental care, and families who are no longer confident in the quality of care provided by network dentists who are willing to accept reduced reimbursements."

Tricare officials said the contract requirement that families be able to access a network general dentist within 35 driving miles and book an appointment within 21 days is the same standard that existed under the old MetLife contract. But family advocates said that should be seen as the absolute lowest standard, not the norm.

The bigger issue for her organization, Ruedisueli wrote, is that neither Tricare officials nor United Concordia officials see the complaints as anything out of the ordinary.

"They believe the stories and experiences we are hearing from military families, like yours, and from dentists are simply part of the typical contract transition," she wrote. "Unfortunately, it is impossible for our organization to single-handedly quantify how many families are negatively affected by the new network."

Still, Bono said in her statement that she remains confident in United Concordia.

"When we hear these concerns, it gives us an opportunity to address concerns with our contractor partner to make sure we are responsive to our shared customers' concerns," she said.

"We are monitoring the timeliness of our contractor's responsiveness to all customer service questions -- from how fast we answer the phone, to how quickly we resolve the issues to the satisfaction of our beneficiary," she added. "I'm confident we can sustain this dental plan in a way that meets the needs of our people, and ensures our contractors remain focused on quality and service."

Officials with NMFA are urging families who face provider problems or other issues with the new contract to contact their congressional representatives to complain.

-- Amy Bushatz can be reached at amy.bushatz@military.com.

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