Insurance Contract Analysis

Contract Analysis Service

Regarded as a valuable member benefit since its inception in 1987, the ADA Contract Analysis Service (CAS) was developed based on the common-sense premise that one should always read and understand an agreement before signing it.

This is where CAS comes in handy to educate members, in clear language, on issues concerning contract provisions—thus helping dentists make informed decisions about participating in provider contracts offered. Understanding the contractual relationship before signing helps prevent dentists from later being blindsided by contract provisions. CAS highlights areas that a dentist may wish to request further clarification from the company. Such as:

  • Does the provider agreement limit how much the dentist can charge an insured patient for non-covered services?
  • Or, what type of decisions may result from the company's utilization review programs?
  • How does the contract define the dentist's "Usual" and "Customary" fee?
  • Or, what is the dentist's obligation to his or her patients after the agreement with the dental benefit company is terminated?

Additionally, CAS provides analysis of contracts that offer dental school students scholarships or loans in exchange for a commitment for future employment, and reviews dental management service organization (DMSO) agreements which involve the purchase of a practice.


It is important to understand that CAS does not provide legal advice. Whether each member elects to accept or negotiate the provision, of course, is a business decision that must be made unilaterally by the dentist, in consultation with his or her personal advisors. The ADA encourages members to work with their own attorneys and financial advisors for analysis, advice and guidance. Entry into an agreement has legal consequences, and nothing substitutes for the legal counsel and guidance of your own attorney. However, members are encouraged to take advantage of the ADA CAS, especially as the Health Care Reform legislation, and its implementation, unfolds.

To have a contract analyzed:

  • Fax, mail or email the contract you desire to be analyzed to the MDA, Attention Olivia Wilson, Contract Analysis Service.
  • The MDA will then contact you for additional details if needed, will forward the contract to the ADA and will send the ADA analysis to you once completed.
  • CAS is available at no charge to members who request a review through the MDA. Dentists contacting the ADA direct are charged a $50 fee.

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