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Articles
Delta Dental Grew 20% in 1999, Says
Annual Report
Customer Service Hours Expanded
Eligibility Enrollment Goes Online
Surgeon General Releases Significant
Findings on Oral Health
1999 Cost Containment Report
Delta Dental Plan of New Jersey achieved its biggest
growth increase ever in 1999. New sales topped $31
million, our total business increased to almost $300
million, and we added more than 240 new groups in
1999. These were just some of the achievements highlighted
in our recently published 1999 Annual Report. Other
accomplishments include:
- Meeting all of our Y2K compliance goals.
- Introducing an improved billing system that provides
customers with an itemized and easily interpreted
statement.
- Replacing mainframe hardware and rebuilding our
Image system to make service faster and more efficient.
- Upgrading technology platforms, which will enable
Delta Dental to soon put in place a comprehensive
Customer Service/Internet strategy.
- Maintaining a customer-retention rate of 95 percent-a
rate we have consistently maintained for the past
12 years.
- Processing more than 2 million claims-16% more
than in 1998.
- Answering more than a half million calls in Customer
Service-and answering 75% of all inquiries effectively
and accurately in under one minute.
- Inclusion in one of the nation's most extensive
dental-provider networks, with three out of four
dentists nationwide participating.
To request a copy of the 1999 Annual Report, send an
e-mail to administration@deltadentalnj.com or
call Kelly White at (973) 285-4020.
Starting July 5, Customer Service will be available to take
calls from 8 a.m. to 7 p.m. Monday through Thursday, and
from 8 a.m. to 5 p.m. on Friday. In addition, our Voice Response
System continues to be available 24 hours a day, seven days
a week, to order forms and provide information concerning
eligibility, benefits, and claims paid status, as well as
maximum and deductible balances.
Delta Dental has introduced a new online enrollment feature
for group administrators. Reporting monthly additions and
terminations changes will be easier and more convenient through
the use of our new online process. To participate in Delta
Dental's online eligibility transaction process, each group
must submit their company name, group number, administrator's
full name, phone number, and e-mail address to enroll@deltadentalnj.com.
Once this information is processed, our Premium Billing Department
will assign a password and forward it to the group administrator
via e-mail or by phone. After the group receives notification
from Delta Dental, administrators can visit www.deltadentalnj.com
and click on "Eligibility Enrollment" in "Manager's Office"
to begin using this new feature. Group administrators will
enter their group number and password to access the eligibility
form. After entering their changes and clicking the finish
button, confirmation of the change will be sent to the group
administrator, indicating a successful submission to Delta
Dental. Transactions will be applied to our systems within
two business days. For more information, contact Delta Dental
at enroll@deltadentalnj.com or
call (973) 285-4065.
Oral health matters. That conclusion is drawn in a report
released recently by U.S. Surgeon General Dr. David Satcher
and endorsed by the nation's largest affiliation of dental
plans, the Delta Dental Plans Association, of which Delta
Dental Plan of New Jersey is a member. The much-anticipated
report marks the first time that the U.S. Surgeon General
has dedicated this level of attention to oral health issues,
and includes a number of significant findings and recommendations.
"Everyone concerned with the state of oral health in America
has anticipated this report since it was commissioned in
1997,"
said Walter VanBrunt, President and CEO of Delta Dental Plan
of New Jersey. "As a dental benefits provider, our organization
fully supports the Surgeon General's decision to focus on
this important issue." The report states that, "Oral health
is essential to the general health and well-being of all
Americans and can be achieved by all Americans. However,
not all Americans are achieving the same degree of oral health." Report
findings indicate that Americans have experienced significant
improvements in oral health over the past few decades. Contributing
factors to these improvements include the widespread fluoridation
of municipal water, improved dental treatment options, a
strong emphasis on preventive dental care and the emergence
of dental benefits as a common and valued workplace benefit.
However, not all populations have realized these improvements
in oral health. The Surgeon General says there is a "profound
disparity"
in oral health among population groups, and states that dental
and oral diseases affecting certain populations amount to
a "silent epidemic." "Access to care makes a tremendous difference
in oral health status, and the Surgeon General's Report acknowledges
that availability of insurance increases access to care,"
said Dr. Scott Navarro, vice president, Professional Services
and Dental Director, Delta Dental Plan of New Jersey. "People
with dental insurance visit dentists one and a half times
as often as people without coverage. This often means healthier
mouths, healthier people and cost-effective treatments for
problems before they require more expensive procedures." Just
why is oral health so important? The report references a
number of recent studies establishing strong connections
between oral health and overall health. Dental health affects
some of the body's most essential functions, including speech,
chewing and swallowing. Other studies have demonstrated relationships
between periodontal diseases and systemic illnesses, such
as cardiovascular disease, diabetes and pregnancy complications.
"The Surgeon General's Report on Oral Health provides important
reminders that oral health means more than sound teeth," said
Health and Human Services Secretary Donna E. Shalala, who
commissioned the report. "Oral health is integral to overall
health. Furthermore, safe and effective disease-prevention
measures exist that everyone can adopt to improve oral health
and prevent disease." The Surgeon General's Report outlines
a number of suggested actions, including strengthening oral
health literacy among policymakers and the public, increasing
public/private partnerships to address oral health disparities,
expanding initiatives for health promotion and disease prevention
and accelerating the building of the nation's science and
evidence base on oral health issues. Dental benefits providers
such as Delta Dental Plan of New Jersey can play a key role
in implementing many of the Surgeon General's recommendations.
Delta Dental supports organizations such as the Dover Free
Clinic and Kimball Dental Clinic, which provide dental care
to those in need. Another area where Delta Dental plays an
active role is in public and professional education. Delta
Dental sponsors numerous programs, including:
- Captain
Supertooth, the superhero of dental hygiene, who
visits New Jersey schools to spread the word to students
about the importance of good oral hygiene.
- The Bloomfield Health Careers Foundation, which trains
dental assistants and dental hygienists.
- The Pollack Memorial Scholarship Fund, which provides
graduate dental students scholarships for studies at the
University of Medicine and Dentistry of New Jersey (UMDNJ).
- UMDNJ continuing education for dental students.
Shalala noted, "To ignore oral health problems can lead to
needless pain and suffering, complications that can devastate
well-being, and financial and social costs that significantly
diminish quality of life and burden American society. Together
we can effect the changes we need to maintain and improve oral
health for all Americans and remove known barriers that stand
between people and oral health services."
Delta Dental is proud to retain its role as New Jersey's
leading and largest dental benefits carrier, providing coverage
to more than 1.3 million people through contracts with employers
in New Jersey and Connecticut. Last year alone, Delta Dental
achieved a 20 percent growth rate increase-our best ever.
In 1999, our new sales topped $31 million, and our total
business increased to almost $300 million. These results
were achieved along with some important technological enhancements.
In addition to meeting all of our Y2K compliance goals, we
significantly improved our service levels with a new billing
system; mainframe hardware replacement; and the rebuilding
of our Image system-all of which are making service faster
and more efficient. In 1999, we were able to save our existing
clients and/or subscribers $123.8 million and paid more than
$250 million in benefits. Throughout New Jersey and Connecticut,
more than 240 new groups came to call Delta Dental their
dental benefits service provider of choice, strengthening
our leadership position. Please refer to the Distribution
of Savings chart for a complete list of 1999 savings. For
more information on how we can contain benefit expenses for
your group, please call a Delta Dental Account Executive
at 800-624-2633. Explanation of Terms
- Filed Fees/UCR Concept-Reduction
of billed charges to reflect the participating dentist's
filed fee with Delta Dental, the maximum UCR allowance
or maximum allowable charge under a PPO program. Represents
savings from utilization of network dentists. Also includes
savings when a PPO dentist was utilized.
- Contractual Limitations-Procedures denied due to generally
accepted dental practice or specific contract limitations
such as performance of a procedure in excess of the accepted
standards of frequency. Also includes reduction to payments
due to Table of Allowance, use of prevailing
fee limit for non-par dentists and PPO tables (when
non-PPO dentists are utilized).
- Eligibility Verification-Benefit denials for procedures
rendered during a period of patient ineligibility under
the plan.
- Non-Covered Services-Benefit denials for procedures excluded
from coverage under the group program.
- Dentist Consultant Review-Procedures which are not supported
by diagnostic records or within generally accepted standards
of dental care based on direct review or payment policy
established by Delta Dental's dental consultant. This includes
procedures for which Delta Dental will provide a benefit
allowance for an alternative procedure that is within the
generally accepted standard of care given the diagnosis
or treatment plan.
- Optional Services-Benefit denials or alternate benefit
allowances for dental procedures that are considered optional
and may be performed at the expense of the patient.
- Non-Billable Services-Procedures that are not chargeable
to Delta Dental or billable to the patient. Such charges
may include component costs of a more comprehensive procedure
which therefore do not warrant a separate charge, and services
denied as duplicate submissions.
- COB Savings-Claim dollars saved through the application
of coordination of benefit policies in accordance with
the group contract, including non-duplication COB reductions
where applicable and an enforcement of standard order of
benefit determination rules.
- Total Savings-Sum of savings excluding claims denied
for deductibles, copayments, and plan maximums. In some
instances, savings may include services which, if allowed,
would have exceeded plan maximums.
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