SPECIAL EDITION: 2017 Seminars, Processing Policy Changes
& Free Online Dental Appointment Scheduling
Dental BrushUp Bulletin Delta Dental of Kansas' newsletter highlighting current topics for Participating Dentists and Staff
Register Now for 2017 Seminars!
Register now for 2017 seminars brought to you by Delta Dental of Kansas (DDKS). Visit DeltaDentalKS.com/Register to register for upcoming seminars, and to check for updates on additional 2017 seminars.
PROCESSING CHANGE NOTIFICATIONS
Please note that payment for immediate full or partial dentures cannot be provided unless extractions have been submitted or recorded in the patient's history dated on or before the denture seat date.
Two common causes for immediate denture claims to be denied are:
Avoid claim denial by indicating the date the denture is seated in the patient's mouth as the procedure date on the claim form when submitting claims for payment of immediate full or partial dentures.
Claims for immediate dentures received prior to receipt of the claim for the extractions will be denied using the following reference code:
511 - Seat date of appliance must be on or after the extraction(s) date for benefits to be provided.
This is a processing change, not a change in policy. The policy maintains that "Multistage procedures are reported and benefitted upon completion. The completion date is the date of insertion for removable prosthetics."
Helpful guidelines for submitting claims can be found in section 1 page 4 of the Participating Dentist Handbook. You can access the handbook online by logging in to the Dental Office Services portal.
Reduction in Request for Information
Tired of receiving those pesky Request for Information letters?
To increase efficiencies, effective April 1, 2017 DDKS will change our process for handling claims that are missing specific required information.
New Process for missing information:
As a reminder, a copy of the DDKS attachment requirements is located in the Provider Toolkit through the Dental Office Services portal.
If you have any questions on these policy changes, please contact your Professional Relations Representative.
Brighter ScheduleTM - a simple, online appointment scheduler for your patients
Activate this free value-added service today!
Delta Dental is pleased to announce that we are partnering with Brighter to make it easier for our participating dentists to attract Delta Dental patients to their practice and maximize growth. Brighter is a cutting-edge consumer technology company that specializes in working with dental carriers to connect their members with participating providers.
Through our partnership with Brighter, we offer you two free services:
With Brighter Schedule, you will enjoy:
Activating these free services takes less than 5 minutes. Visit Brighter.com/DeltaDental or call 888.328.5414 to speak with a Brighter Provider Success Specialist.
Delta Dental is launching the schedule feature to your patients later this month. To ensure that your Delta Dental directory listing is highlighted for online scheduling, please activate your free services through brighter at your earliest opportunity.
Click here to activate Online Scheduling for Delta Dental patients.
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Dental BrushUp BulletinDelta Dental of Kansas' quarterly newsletter highlighting current topics for Participating Dentists and Staff
Insurance ID Cards
As you are aware, not all employer groups provide printed insurance cards for their employees and even if they do, your patient may not bring it to his or her appointment. Please remember that your patient can obtain an electronic copy of their card either by downloading the Delta Dental App using their smartphone or by accessing and printing a copy of their card from the Delta Dental website. Because there are many Delta Dental member companies, if you are not sure of the Delta Dental that administers dental benefits for your patient, ask them for the state in which the employer’s home office is located.
Thank You For Your Patience
We are aware that some of you are experiencing unusually high wait times when calling our Customer Service department. We ask for your patience during this busy time of year when our call volume is high due to many patients experiencing group plan changes. We apologize for any inconvenience. Please know our Customer Service department is doing everything possible to normalize these calls.
As alternatives to calling to obtain benefit rundowns, please consider the following ways of obtaining benefit information:
To avoid long wait times, if you are calling about patient benefits, you can find this information on our website. Log in to the Dental Office Services portal, then click on the Kansas Provider Toolkit link to find the Patient Benefits option.
Many dental offices are without adequate internet access and use our Fax Back service as an alternative to looking up patient benefits online. We are pleased to report that we recently updated the Fax Back to now include frequency information. See the example below where Frequencies are shown on page 2 of the Fax Back.
To take advantage of the Fax Back service, just dial 1.877.FAX.DDKS (329.3357) or 316.462.3360. You will get an automated voice response that will lead you through simple instructions. Fax Back is available to all Participating Providers and does not require enrollment.
Network Directory Accuracy Update
As you may recall, the October 2016 BrushUp newsletter provided information about the importance of directory accuracy and the methods by which DDKS will monitor and verify the accuracy of the directory made available to Delta Dental subscribers. The following was added to the “What You Need to Know” section of our 2017 Participating Dentist Handbook:
Delta Dental is required to maintain accurate provider directories. This ensures that patients can locate active providers at listed locations. Please notify DDKS immediately when a dentist separates from any treatment location.
DDKS conducts random audits that include, but are not limited to, personal visits and/or phone calls to dental offices. For a dentist's location to be listed in our provider directory, he or she must regularly schedule treatment at that location.
2017 Participating Dentist Handbook Available
The Delta Dental of Kansas Participating Dentist Handbook, also known as the Processing Policies and Procedures Reference Guide, is a helpful and handy reference tool for both dentists and staff. This guide contains current Codes on Dental Procedures and Nomenclature (CDT Code) along with the corresponding National Delta Dental processing policies.
You will also find the recently updated “What You Need to Know” section in the first several pages of the handbook. This section contains information covering membership, credentialing, submitting claims and predeterminations, appeals, electronic services and several other topics.
Participating dentists must familiarize themselves with the Dentist Handbook. It is available on our website. To locate the PDF document, log in to the Dental Office Services portal then select ‘Participating Dentist Handbook’. If you need assistance creating your username and password or help navigating our website, please contact customer service at 800.234.3375 or your local PR representative.
Some Key Points from the Handbook:
The handbook has been revised to reflect requirements set forth under the Administrative Simplification Provisions of the Health Insurance Portability and Accountability Act of 1996
(HIPAA) and related regulations. It is the policy of Delta Dental to comply with all requirements as well as to require all participating dentists to comply. To be consistent with HIPAA, Delta Dental exercises its right to determine claims reimbursement procedures and requires the processing of such codes in accordance with National Delta Dental policies, unless prohibited under other applicable law or specific group contract provisions. Such policies include charging correct amounts for procedures without inflation or manipulation.
Regardless of the network, participating dentists cannot balance bill beyond the maximum plan allowance (based on each product) except for contractual non-covered services. Participating dentists must accept their approved maximum plan allowance for all contractually covered services even when the fee is not payable because of a deductible, for benefits with frequency limitations or waiting periods, or for services performed after the patient reaches his or her annual maximum benefit.
Delta Dental dentists are automatically part of the national Delta Dental Premier program once contracts are signed and approved. As a participant in this national program, you must accept the payment and claims processing policies set forth by Delta Dental. Please note: the Delta Dental PPO program is an optional program for participating dentists and a separate contract is required.
HELP NEW PATIENTS FIND YOU!
Update your online profile to better advertise your practice
All participating dentists are included in our online directory so that patients can find dentists practicing near their home or work. The directory is also useful when plan participants travel and require emergency dental care. Delta Dental Plans Association launched an initiative to provide more details and attributes about each dental practice to Delta Dental subscribers, who are also potential patients.
Here is an example of what a provider profile might look like today:
And here is an example of what a provider profile could look like after updating the online profile:
When users hover over the icons, a description for that icon is viewable. As an example, the first wheel chair symbol in the picture above indicates that the office is wheelchair accessible. The second and third indicate treatment of disabled adults and disabled children. Also, note that the online search provides a direct link to your website once a URL is added to the office profile.
DDKS has information about our participating providers that includes gender, education and degrees. Other user-defined options include office hours, languages spoken, whether or not treatment is available for disabled adults and/or children, handicap accessibility, public transportation, and whether an office is accepting new patients. Any information currently available to DDKS is automatically displayed in your online profile, but it is up to the dental office to update the remaining information.
To update your online profile:
Log in to the Dental Office Services Portal
Click the “MISCELLANEOUS” link at the bottom of the left list of options
Click “Edit Your Profile”
Click “Save” to save your updates
Generally, within 24-48 hours, saved updates are available in the online dentist search.
If you have any questions about updating your online profile, please contact customer service at 800.234.3375 or your area Professional Relations representative.
DELTA DENTAL INDIVIDUAL & FAMILYSM DENTAL PLANS
New 2017 Rates
DELTA DENTAL OF KANSAS ORAL HEALTH GRANTS
Improving Oral Health Access for Those in Need
Through Delta Dental of Kansas’ (DDKS) 2016 Community Dental Health Grant cycle, Exploration Place was granted $17,385 to fund oral health educational programs for preschool classes (3 and 4 year olds) that predominately serve at-risk families. The programs will increase knowledge about the importance of oral health care and help families change behaviors to improve their personal oral health care.
DDKS donated over $450,000 to Kansas-based organizations through its 2016 Community Dental Health Grant cycle. With these grants, organizations run programs, initiatives and events promoting the prevention of dental disease that have a significant impact and/or are sustainable and innovative solutions to oral health issues in Kansas.
Important Dates & Upcoming Events
Keep in Touch!
If your practice is changing email addresses, please let us know! Email your updated information to firstname.lastname@example.org.
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