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Newsletter | December 2018

Delta Dental of Kansas updates to participating dentists.

END OF YEAR UPDATES

Delta Dental Participating Dentist Handbook -

The dentist handbook is an extension of the Participating Dentist Agreement and is designed to provide important information related to the general processing policies and guidelines for all ADA CDT procedure codes, along with other helpful information such as definitions, submitting claims, appeals and using electronic services. 

The 2019 handbook will be available online by December 31, 2018. To access, log in to your dentist account at DeltaDentalKS.com and click on the "Documents & Dentist Handbook" section.

If you need assistance creating a dentist account or need help navigating the website, contact our Customer Service team at 800.234.3375 or your Professional Relations Representative.

Delta Dental PPOTM Fee Schedule -

The 2019 Delta Dental PPO Fee Schedules were mailed on November 14 to all general dental offices participating in the Delta Dental PPO network. The PPO Fee schedule is also available online, in the "Documents & Dentist Handbook" section of your dentist account at DeltaDentalKS.com.

Contact your local Professional Relations Representative if you would like to participate in or learn more about the PPO network - or send an email requesting more information to pr@deltadentalks.com.

Detailed Dentist Snapshot (DDS Report) -

We've made it easy for you to access the reporting you want. Check out the "Dentist Snapshot Report" in the "Reporting" section of the Kansas Provider Toolkit at DeltaDentalKS.com. In this report you'll find:

  • all procedure codes submitted within the selected reporting period
  • your most commonly submitted fee for each procedure and the allowed Premier and PPO amounts
  • your percentage of Premier and PPO patients (regardless of your participation status)
  • your number of claims submitted and the percent that were submitted electronically
  • direct deposit enrollment details
  • your top denied codes and explanation
  • the number of calls made by your office to us and the purpose of the calls
  • patient trends in your practice
  • the top Premier and PPO groups that make up your patient base
 

Are you registered for an online dentist account?

It's an easy and quick way to look up your Delta Dental patient benefits, access forms, reports and other important information.

 

2019 CDT Procedure Code Changes

The American Dental Association has published the new procedure codes for 2019. Changes include: 15 new codes, 4 deleted codes and 7 revised codes.

To order CDT 2019 items, visit adacatalog.org or contact the ADA at 800.947.4746

 

Please note: the listing of procedure codes does not mean that the procedure code is a covered or reimbursable benefit within a dental benefits plan. 

Processing Policy Changes

Effective 1-1-19

 

D8660 Pre-orthodontic treatment examination to monitor growth and development – This procedure code is not a benefit for patients with orthodontic history. A “pre” orthodontic visit must be performed on a date preceding orthodontic banding or delivery of aligners. Fees for D8660 submitted on the same date of service as D8070, D8080 or D8090 are not billable to the patient.

Explanation: A “pre” orthodontic visit must be performed on a date preceding orthodontic banding or delivery of aligners.

 

Evaluations – age limitation changes D0145 oral evaluation for a patient under three years of age and counseling with primary caregiver.

The following codes are for patients ages 3 years and older

  • D0150 (comprehensive oral evaluation – new or established patient) 
  • D0160 (detailed and extensive oral evaluation – problem focused, by report) 
  • D0180 (comprehensive periodontal evaluation – new or established patient)

Claims will be processed based upon the appropriate evaluation code according to age. D0120 (periodic oral evaluation – established patient) remain valid for ages 0-99.

 

Keeping You Informed

Employer Group Plan Design Changes

Effective 1-1-19

  • Amarr Entrematic (Group #1498) - Diagnostic and Preventive changing to two (2) times per calendar year. Periodontal surgical re-entry frequency limit changing from 24 months to 36 months. Adding Preventive Plus*.
  • Axcet HR Solutions (Group #50064) - Adding posterior composite coverage.
  • Georgia Pacific (GP) (Group #53000, #53001, #53002) - Adding Preventive Plus* to group #'s 53000-0-1-0, 53000-0-2-0, 53000-0-3-0, 53000-0-4-0, 53001-0-1-0, 53001-0-2-0, 53001-0-36-0, 53001-0-37-0. Adding adult orthodontics to Flex Ortho only (53000-0-3-0, 53000-0-4-0). Changing orthodontic age to 26 on ALL GP groups that include orthodontic coverage.
  • Koch Industries (Group #50950) - Adding Preventive Plus* (excludes group #50951).
  • Stormont Vail Healthcare (Group #91504) - Adding adult and child orthodontics with $1,000 separate orthodontic maximum. Adding deductible of $50/person up to $150/family (was previously no deductible).
  • YRC (Group #90305, #90405, #90505, #90705, #92305, #92405, #92505, #92605) - Adding Incentive Plan (Benefits will increase from the base level to the incentive level if the member receives a routine exam and/or cleaning at least one (1) time in twelve (12) months. Benefits will increase to the incentive level ninety (90) days after a cleaning and/or exam. Benefits for new members will begin at the incentive level. After twelve (12) months, benefit levels will be determined by the date of the last Diagnostic or Preventive treatment).

*Preventive Plus - Diagnostic & Preventive services do not accumulate to Annual Maximum.

Please be aware plan changes may occur at the beginning of a plan year. Plan rollovers occur throughout the month of December for the new year, to verify current year accruals contact Customer Service at 800.234.3375.

As a best practice, we recommend that you verify patient coverage and benefits each time your patient seeks treatment at your office. You can easily check by logging in to your dentist account at DeltaDentalKS.com

*New group Announcement* - Pfizer employees will be covered under the Delta Dental PPO plan through Delta Dental of New York effective January 1, 2019. Delta Dental of New York’s contact center is happy to answer any questions about this transition. Please feel free to call 888-893-4411.

 

Delta Dental Individual & FamilySM Platinum Plan Rates are Changing in 2019

2019 brochures for Delta Dental of Kansas' Individual & Family plans have been mailed out. These updated brochures have the correct rates for 2019. 

 

Please use the 2019 brochures and discard the old brochures. Any enrollee who enrolls AFTER November 25, 2018 will have a 1-1-19 start date, and will have the 2019 rates.

Please send requests for additional brochures to pr@deltadentalks.com.

 

Using the Delta Dental logo to promote your practice?

You're welcome to use the Delta Dental logo to promote your practice - here's how:

 

DDKS Reminders:

Matching Gift Program for Participating Dentists:

Delta Dental of Kansas will match approved charity donations made by a participating dentist within the 2018 calendar year up to $100. Eligible organizations include any non-profit charitable health care, education, civic or cultural organization provided it is located in Kansas and recognized as a tax exempt organization by the IRS under Section 501(c)(3).

2018 Matching Gift Applications must be submitted by December 14, 2018 to Delta Dental of Kansas' Community Benefit department at corpcomm@deltadentalks.com.

 

To view a list of approved organizations, access the 2018 application and learn more about the matching gift program, visit DeltaDentalKS.com/CommunityBenefit/MatchingGiftProgram.


Delta Dental of Kansas office will be closed:

December 24 & 25 - Christmas

January 1 - New Year's Day

 

Upcoming Events

Understanding Dental Insurance Seminar Opportunities:

3/1/2019 - Leawood, KS (9 a.m. - 12 p.m.)

3/8/2019 - Wichita, KS (9 a.m. - 12 p.m.)

Registration and more information coming soon at DeltaDentalKS.com/Register

 

Dental Office Changes or Updates? Please notify us.

Please contact the Professional Relations team with any dentist and/or office changes or updates. When to notify us:

New and/or change of physical or payment address(es)

New and/or change of phone number(s)

A dentist joining or leaving

Closing of an office

Tax information changes

New and/or changed NPI information

Retirement

Sale or purchase of practice

License status updates

 

Questions?

Contact your Professional Relations Team at

pr@deltadentalks.com or 316.264.1099.

Meet your Professional Relations Representative

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Delta Dental of Kansas | DeltaDentalKS.com | 800.234.3375