News for Network Dentists and Staff from Delta Dental of Kansas (DDKS)
Dental Benefits and the Healthcare Marketplace
What you need to know as a dental provider
In October 2013, we distributed an email to offices for which we have an email address. The topic was health care reform and how its provisions will affect individuals and small business owners based on information available to date. Following is an overview of the content:
- On-exchange: two POEHB plans.
- Off-exchange: two exchange-certified POEHB plans plus three Delta Dental Individual and Family plans.
More than 5,000 Kansans have taken advantage of individual and family coverage. Visit deltadentalks.com/IndividualOptions to learn more. Contact your Delta Dental representative for brochures to display in your office.
DDKS Announces New President & CEO
DDKS’ Board of Directors has selected Michael Herbert as the next president and CEO of the company. In this role, he will be responsible for leading the oldest and largest dental benefits carrier in the state, providing strategic direction for the company and representing Kansas to the national Delta Dental Plans Association.
Herbert has been serving as the interim President and CEO since June 2013. He joined Delta Dental in December 1999 as Vice President, Finance; his most recent position has been Chief Financial Officer.
Dr. Lucynda Raben, board chairperson, said, “Mike’s unwavering leadership and commitment to Delta Dental during a time of transition has been outstanding. We recognize that in this case the best talent is grown from within and the Board of Directors is confident Mike’s leadership abilities will serve the company well into the future.”
Did You Know?
Coordination of Benefits can be automatic and direct deposit will help
Did you know...Delta Dental (primary and secondary) coordination of benefits can be automatic? This is a very common question we get when both primary and secondary are covered by Delta Dental of Kansas. You may find that some secondary claims will process automatically and others do not, which is confusing. You may also find that when your staff submits a secondary claim, you might receive a denial as a duplicate. If DDKS is aware of the dual coverage it links the accounts together. Once the primary claim has processed, our system will automatically begin processing the secondary claim. Please note that the secondary claim may not pay out until your next weekly payment. Please do not submit another claim until there has been enough time for both to process, usually 7 business days.
If you have reason to believe that an account is not properly linked, you can contact customer service before submitting a secondary claim to verify and to check whether or not the secondary claim is in process. This call helps us locate those few accounts that need linking, which we greatly appreciate.
Another option to reduce confusion is to enroll in our electronic funds program (EFT) (also known as direct deposit). Enrollment provides several advantages. For example, when you file your claims electronically using a clearinghouse or our website, you can receive daily payments rather than weekly payments, which results in these dual coverage situations paying out closer together.
EFT is convenient:
DDKS has no authority to inquire about or withdraw funds from your account. EFT enrollment only authorizes us to make deposits into your designated bank account.
EFT enrollment is simple and following a recent system enhancement, can be performed directly on our website by clicking on the EFT link after logging in to Dental Office Services at www.deltadentalks.com/dentists.
National Delta Dental Policy Update: Claim Submission of D4910
D4910 no longer paid as D1110 before history is obtained
An adult and child prophylaxis (D1110, D1120) are two of the highest-utilized procedure codes. A person under age 14 is usually considered a child for benefit determination purposes only or unless otherwise stated in the individual or group contract. While the prophy frequency is generally twice a year or every 6 months, it is established by your patient’s contract. Additional prophys are optional and may be charged to the patient. Periodontal maintenance (D4910) and full mouth debridement (D4355) are counted toward the contract limitation for the prophy.
The current Participating Dentist Handbook and CDT 2013 states that the D4910 procedure is performed “following periodontal therapy and continues at varying intervals, determined by the clinical evaluation of the dentist, for the life of the dentition or any implant replacements. It includes removal of the bacterial plaque and calculus from supragingival and subgingival regions, site-specific scaling and root planing where indicated, and polishing the teeth. If new or recurring periodontal disease appears, additional diagnostic and treatment procedures must be considered.”
Unfortunately even with these guidelines, Delta Dental continues to receive the submission of D4910 with no history of periodontal therapy, surgical or non-surgical. We request the history but often it is not provided within the required 14 days. In the absence of the requested information, the claim is paid as a prophylaxis (D1110). After payment is made, we often receive the requested history. This results in claim adjustments, refund requests and unnecessary time spent in both offices. As of January 1, 2014, we will continue to request the history but if there is no response we will no longer pay the D4910 as a D1110 automatically.
If the history is not received within the allotted time frame, we will deny the claim using a reference statement of “requested information not received” and a new claim will need to be submitted with the history that was originally requested. Please contact your Professional Relations representative if you have any questions regarding this processing change.
New Risk Assessment Codes Effective January 1, 2014
Risk assessment tools encourage patient education
Wouldn’t it be nice for your patients to know if they were at risk for oral disease before it became a problem? Many patients depend upon you, the dentist, to direct them in every aspect of their dental health. The better our oral health, the healthier we are overall.
Effective January 1, 2014, the CDT 2014 Dental Procedure Codes now includes risk assessment codes requiring the use of a recognized assessment tool. They will only be covered once in a 3-year period for children ages 3-19. See the processing manual for more details.
The new codes are:
Code 0601 – caries risk assessment and documentation, with a finding of low risk
Code 0602 – caries risk assessment and documentation, with a finding of moderate risk
Code 0603 – caries risk assessment and documentation, with a finding of high risk
Risk Assessment Tools
While there are a number of sources that provide assessment tools like Cambra, ADA, Cariogram, etc.
Delta Dental is working with PreViser to provide an assessment tool called “myDentalScore” that generates estimated dental scores. By taking just a few minutes to answer some simple questions about themselves and their oral health, myDentalScore.com will assess your patient’s level of oral disease risk and their oral health needs.
This tool was developed to help the patient make the connection between their overall health and the health of their teeth and gums. Once they have obtained the Estimated Dental Scores, they are encouraged to discuss the results with you, the dentist, who can verify the scores with information collected during a professional dental examination.
There is also an analytic version for the dentist that gives you an easy-to-use way to measure, understand, and communicate your patients’ risk and disease level as simple numeric scores. With these scores, you can track changes in risk level and disease severity over time to evaluate treatment effectiveness and outcomes. This is said to provide a more productive practice delivering the highest quality of care to your patients. Please visit apps.previser.com/emds2 to find out how you can help your patients identify opportunities to improve their oral and overall health. Also, find more dentist-specific information at www.previser.com/dentists.
Please note: myDentalScore.com is an educational tool only. It does not provide dental or medical advice, diagnosis or treatment.
Check Your Tax ID #
Please be sure the current Tax Identification Number (TIN) that Delta Dental has on file matches the one you use to report earnings to the IRS. Registered users of Delta Dental of Kansas’ online Dental Office Services can verify a TIN by logging in at www.deltadentalks.com/dentists. Please contact Professional Relations at email@example.com or 800-733-5823 if you have corrections or questions.
CDT 2014 and Fee Schedules Coming Soon
If you are a Delta Dental PPO or Delta Dental Patient Direct provider, the 2014 fee schedules will soon arrive in your mailbox. If you do not receive your copy by December 18, please contact your Professional Relations representative. In CDT 2014, there are 29 additions, 4 deletions and 18 revisions.
Effective January 1, 2014, the updated Processing Policies and Reference Guide (PPRG) will include these updates and their respective processing policies. To access the PPRG, visit www.deltadentalks.com/Dentists. Login to Dental Office Services, click ‘Documents & Dentist Handbook’ then ‘Dentist Handbook’.
As a reminder, due to HIPAA requirements, Delta Dental can only accept claims showing current codes. Expired codes will not be accepted for services rendered after January 1, 2014. Dental offices submitting invalid codes will be instructed to resubmit the claims using the correct codes.
2014 Group Plan Changes
In 2014, Garmin employees will have the opportunity to purchase a Buy-Up plan. The new plan option includes a $1,500 annual maximum, $1,500 lifetime orthodontia maximum and major services are covered at 80% instead of 70%.
Mark Your Calendars
Kansas Mission of Mercy (Dodge City)
February 28 - March 1, 2014
UMKC Midwest Dental Conference
April 10-13, 2014
DDKS’ Educational Seminar (Overland Park)
August 9, 2014
News for Network Dentists and Staff from Delta Dental of Kansas (DDKS)
Join Dr. Kohn for the 2013 Educational Seminar in Wichita
Delta Dental of Kansas (DDKS) invites participating dentists and their clinical staff to attend its free Educational Seminar.
During the August 10 Educational Seminar, Dr. Bill Kohn, Vice President for Dental Science and Policy with Delta Dental Plans Association, will provide new information and insights regarding the latest regulations on Health Care Reform from a national perspective. Specifically, Dr. Kohn will explain how this may impact your dental office. You will also learn about additional requirements on Quality Assurance (e.g., risk assessment, Cambra, evidence-based guidelines, quality measures) based upon the ADA guidelines and reporting using diagnostic codes.
Register online. If you prefer paper registration, forms were mailed in late June to all participating dentists. RSVP by August 2.
Annual Membership Meeting Notice
All participating dentists are invited to attend DDKS’ Annual Membership Meeting Saturday, August 10, at 12 p.m. at the Hyatt Regency in Wichita, Kan. A Nominating Committee was selected, as required by Delta Dental’s bylaws.
The following candidate is nominated for election to the Board of Directors:
* Dr. Brick Scheer
Additional nominations for the vacancy may be made by written petition containing the name nominated, signed by at least ten (10) members in good standing and delivered to Jerry Goforth, Chairman of the Board, at least five (5) days prior to the annual meeting.
Jerry Goforth, Chairman
Delta Dental of Kansas
P.O. Box 789769
Wichita, KS 67278-9769
Encourage Your Patients to Take the Oral Health Challenge
DDKS and the Wichita Wingnuts want your youth patients to have healthy teeth and gums. If you practice in the Wichita area, encourage your
patients to take the Oral Health Challenge –
brush twice and floss once daily during a
one-week period to earn free tickets to the
July 23 Wichita Wingnuts baseball game.
Find the challenge checklist and online submission form.
Did You Know?
Resources available for oral health promotions
Did you know...that Delta Dental promotes oral health in more ways than simply paying benefits?
There are many resources available to our participating dentists that can be used to help them in
their everyday job of promoting oral health. For example:
• Along with providing quality dental benefits, DDKS has oral health information readily available for
your patients by topic, term and specialty. Our online Wellness Connection is a vast resource for
topics such as pediatric oral health, adult oral health and oral cancer. See for yourself the great
information available at www.deltadentalks.com/aboutus/wellnessconnection.
• Let your uninsured patients know that DDKS offers Delta Dental Individual and Family – affordable
individual dental plans that can be purchased directly by individuals and families. More than 4,000
people are enrolled in these plans. Learn more at www.deltadentalks.com/individualoptions.
Interested in Delta Dental Individual and Family brochures for your office? Contact us.
• In 2013, Delta Dental Plans Association commissioned a national survey of children’s primary
caregivers to gain insight about their oral health knowledge. This information can be shared with your
patients and is also an interesting read. View and/or download the full Children's Oral Health Survey.
DDKS Announces Dental Office Deals
Discounts available for participating dentists
If you’re a participating Delta Dental dentist, be sure to check out Dental Office Deals. This value-
added program provides discounts on products and services for your practice. Vendors include
FedEx, Office Max, Nestle Water, Paychex, At&T, Staples, Verizon, and more. In addition, Sprint, a
Kansas-based company has monthly specials for participating dentists.
As of May, participating dental offices in Kansas projected an annual savings of over $60,000 by taking
advantage of these discounts. Find out more about these offers.
Delta Dental of Kansas facilitates the Dental Office Deals program but does not receive
any compensation from vendors for doing so. Please note that vendors deal directly with the
participating dental office. Delta Dental will do its best to maintain vendor participation and add
new vendors to provide even more value. However, we cannot guarantee the performance or continued
participation of these vendors. DDKS does not warrant or guarantee these products, nor will it be
liable for or accept responsibility for them. Each purchaser must make his or her own analysis and
Password Updates/Security Measures
Alter online passwords after personnel changes
We know that dental providers and staff members care deeply about the safety and security of patient data and health information, plus patients trust that their information is kept confidential. DDKS also cares about maintaining the security of patient information, which is why we address the importance of updating passwords and other essentials.
Many providers use online services offered by Delta Dental and other carriers. Maintaining and updating passwords is an important step in safeguarding the security of your patient’s electronic data. We recommend that you take the following steps to safeguard your patients’ information:
1. Routinely audit and test your security system
2. Change and update passwords after employee turnover
If you experience a personnel change, we strongly suggest changing your password within the following DDKS platforms:
Electronic Funds Transfer (EFT)
To update the password used to access your direct deposit/EFT web retrieval reports, a new EFT/Web report retrieval form must be completed, signed by the dentist(s), then forwarded by fax (316.462.3324) or mail to:
P.O. Box 789769
Wichita, KS 67278
This form is available within Dental Office Forms section of Dental Office Services.
Dental Office Services portal
If you share one Dental Office Services account, update your password by logging into Dental Office Services. On the landing page, click ‘change your password’ then create and save a new password. Store your new password in a safe location.
You may wish to create separate accounts for each staff member with web service access. In the case of personnel changes, a specific account can be deactivated by calling DDKS’ customer service department at 800.234.3375. Have specific questions? Please contact your Professional Relations representative.
Dr. Raben Selected as Dental Champion
Congratulations to Dr. Lucynda Raben (Wichita), a DDKS Board member,
for being selected to Oral Health Kansas’ 2013-2014 Dental Champions class.
Other dentists included in this class are Dr. Charles Abbick (Salina),
Dr. Lisa Metzen (Minneapolis) and Dr. Cindi Sherwood (Independence).
2012 Annual Report Available Online
Check it out at deltadentalks.com.
DDKS will be closed in observance of Labor Day on September 2, 2013.
Delta Dental of Kansas Foundation Focus: The Champions Project
In May 2013, DDKS and the DDKS Foundation announced grant recipients for The Champions Project, a state-wide online mini-grant contest. In total, 38,567 votes were cast. The three organizations that received the most votes over the three-week contest were each awarded $5,000 mini-grants.
E.C. Tyree Dental Clinic (Wichita) took the top spot with the most votes. Clinic staff will use the $5,000 to support their Healthy Smiles program, which includes school screenings, sealants, fluoride varnish and oral health education materials. Other grant recipients included GraceMed Health Clinic (Wichita) and Marian Clinic (Topeka). The Champions Project is in addition to the DDKS Foundation’s annual grant program.
P.A.N.D.A. Coloring Contest Winners
DDKS' Prevent Abuse and Neglect through Dental Awareness (P.A.N.D.A.) program celebrated happy, healthy children in April with a Coloring Contest! DDKS employees selected a winner for each category.
Ages 0-3 – Brady Kelley, age 2, from Dr. Brenton Bennett’s office in Emporia, Kan.
Ages 4-7 – Nathan Barron, age 6, from Dr. Mariah Frazier’s office in Wichita, Kan.
Ages 8-10 – Keagon Taylor, age 9, from Dr. David Cobb’s office in Olathe, Kan.
Thank you to all the dental offices that participated. Learn more about the P.A.N.D.A. program.
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