Articles
Benefits Managers Give Delta Dental Highest Marks Ever
'Benefits Connection' Helps Out-of-State Mom
Compliance Initiatives Are in Full Swing at Delta Dental
Tracey Bucher Named Customer Service Representative of the Year
Need Information About Delta Dental? It's Probably on Our Web Site
Delta Dental Facts
Dentists Can Submit Claims to Delta Dental Via the Internet
Value of Dental Benefits
Subscriber Satisfaction Survey Under Way

Benefits Managers Give Delta Dental Highest Marks Ever

More than nine out of 10 benefits managers are "extremely satisfied" or "very satisfied" with Delta Dental, and 98% of you would recommend Delta Dental to other administrators. Brownstone Information Resources, Inc., an independent market-research firm in Morristown, New Jersey, conducted telephone interviews with 250 benefits managers selected at random.

Additional findings:

• More benefits managers than ever have Internet access at work. Eight in 10 of you use the Internet at work. Seven in 10 would use the Internet to submit eligibility changes and updates, as well as obtain listings of dentists in their local area. (Delta Dental now offers both these capabilities through our Web site at www.deltadentalnj.com).
• Benefits managers believe their employees are also satisfied with Delta Dental. Eight in 10 of you said your employees are "extremely" or "very happy" overall.
• Most benefits managers spend less than one hour per week assisting employees with Delta Dental claims or problems. More than 80% of you spend less than one hour a week assisting employees with Delta Dental issues. More than nine in 10 of you said this was about the right amount of time or less time than expected.

How benefits managers rated our performance:

'Benefits Connection' Helps Out-of-State Mom

No one likes hearing the news, "Your daughter's wisdom teeth have to come out." But when you're a single parent, the pronouncement can be especially worrisome. "How much coverage will my dental benefits provide?" "Where can I find an oral surgeon?" "How can I best manage my dental benefits while doing what is best for my daughter?"

Vickie Waters, a business analyst with Roche in Indianapolis, Indiana, relied extensively on Delta Dental's Benefits Connection during this critical time. Even though she lives outside of New Jersey, "I found everything I needed on the Web site, including the benefits available to me," she says. "I even used the site to find the surgeon we used."

She also used Benefits Connection to check the claims processing status. "As a single mother, cash flow is very important. I needed to know when money would be reaching me so I could get it to the dentist. Benefits Connection enabled me to do that." It also informed her if her dentist needed to send Delta Dental additional information to process claims.

She especially liked the fact that Benefits Connection clearly listed her daughter as her dependent. "It gave me a warm, fuzzy feeling to be reassured that my daughter was covered, even though she has a different last name than mine, and knowing that the dentist could see right away that she was covered. It helped smooth things out a lot."

Benefits Connection enables subscribers and their dentists to check benefits and claims information online. To access it, go to www.deltadentalnj.com, click Subscribers, then log on at the Benefits Connection Logon screen.

Information available through Benefits Connection includes:

• A complete explanation of eligibility and coordination of benefits for subscribers and their covered dependents.
• A description of the subscriber's Delta Dental plan.
• Details on the types of services covered.
• Percentage covered for each service.
• Any applicable deductibles and waiting periods.
• Explanations of any maximums and age limitations.
• Frequency schedule.
• Procedure code search.

Compliance Initiatives Are in Full Swing at Delta Dental

Delta Dental is committed to complying with both state and federal regulations and has hired a full time compliance manager, who can be reached at compliance@deltadentalnj.com. Several of Delta Dental's compliance initiatives are summarized below.

Health Insurance Portability and Accountability Act (HIPAA)
Delta Dental Plan of New Jersey has filed with the Centers for Medicare and Medicaid Services (CMS) for the extension on the HIPAA compliant transactions. Delta Dental will have until October 15, 2003 to achieve full compliance.

The Accredited Standards Committee X12N Insurance Subcommittee recently approved all of the amended versions of the Implementation Guides. It is anticipated that the CMS will publish them in the near future. These Implementation Guides will be used by organizations to achieve HIPAA compliance by October 15, 2003. Delta Dental Plan of New Jersey has played an active role in this process and will be working over the next several months to gain compliance.

Delta Dental is also actively working toward compliance with the recently finalized privacy regulations. Over the next few months Delta Dental will complete and mail its Notice of Privacy Practices to all subscribers it covers as a covered entity (coverage written on a "risk" basis). In addition, Delta Dental will issue Business Associate Agreements to all of its self-funded clients and to its Contractors.

The Privacy regulations restrict access to, use of and disclosure of Protected Health Information (PHI). They will not have a significant impact on our claim processing because Delta Dental already adheres to a privacy policy, which protects against unnecessary and/or unauthorized disclosures. There will, however, be changes, especially with respect to the information Delta Dental can provide to its covered groups. The Privacy regulations go into effect April 14, 2003.

NJ SHORE
Delta Dental Plan of New Jersey is also a member of NJ SHORE - New Jersey's Strategic HIPAA/Healthcare Organization & Regional Effort. This organization was formed to assist in addressing statewide HIPAA Administrative Simplification implementation readiness and Health Information Electronic Data Interchange Technology Act (HINT) compliance. NJ SHORE is made up of volunteers from the healthcare industry. Anyone interested in participating in this organization should contact NJ SHORE member Rosanna Dovgala at 973-429-0044, ext. 232.

United States Department of Labor (DOL)
The DOL has issued requirements for the processing of claims and the handling of appeals for persons covered under ERISA plans. Delta Dental is changing its processes and workflows to comply with these new requirements. By January 1, 2003, our Explanation of Benefits (EOB) statement will contain specific notices that pertain to rights of appeal for covered members and/or their authorized representatives and will provide expanded times for patients to file appeals.

Coordination of Benefits (COB)
The Department of Banking and Insurance of the State of New Jersey released new guidelines on how claims involving two or more carriers should be processed. Within the regulation, the department provided 27 different COB examples. Delta Dental is changing its systems to be in compliance with these requirements by January 1, 2003.

New Web Site Compliance Information at www.deltadentalnj.com
Delta Dental Plan of New Jersey has added an informational and educational HIPAA section to our Web site, which also links to other important HIPAA sites. We've also added new sections, under the respective Dentists, Employers, and Brokers pages, dealing with Delta Dental's Compliance with New Laws. Please visit Delta Dental's Web site at www.deltadentalnj.com for the most up-to-date information on our compliance efforts.

Tracey Bucher Named Customer Service Representative of the Year

Tracey Bucher, Customer Service agent with Delta Dental Plan of New Jersey, was one of three individuals named Customer Service Representative of the Year by the Garden State Chapter of the International Customer Service Association. Chosen by a group of her peers, Bucher won the award for her ability to consistently demonstrate skills and professionalism that result in the greatest levels of customer satisfaction.

Bobbi Homeyer, her team leader at Delta Dental Plan of New Jersey, nominated Bucher for the award. "Tracey is a shining example of what we look for in an employee," said Homeyer. "Her friendly and professional demeanor is well received by customers and exemplifies the level of customer service that our company prides itself on. Tracey's patience, knowledge, and positive attitude contribute to her success, and enable her to turn around some of the most challenging calls."

The Customer Service Representative Awards were presented by Debra Breidt, President of the Garden State Chapter of the International Customer Service Association, which is the New Jersey chapter of the 2,000-member national organization. The Garden State chapter has approximately 100 members who network throughout the year to discuss topics such as technology, hiring, and customer retention. Through a nomination process, the organization presents one award annually to the customer service representative, or in this case representatives, who truly go above and beyond their job description. The award is given in the first week of October to coincide with National Customer Service Week.

Bucher has been a Customer Service agent with Delta Dental for two years. 

Need Information About Delta Dental? It's Probably on Our Web Site

Delta Dental's Web site, at www.deltadentalnj.com, contains a treasure trove of information designed to make your job easier. Here are just some of the items available online for you:

• Descriptions of each of our products. Click Products on the left navigation bar.
• Reports detailing Delta Dental's cost containment efforts. Click Brokers on the right side of the home page to access your special section of our Web site. Click Cost Containment for the overall results of our cost containment efforts in 2001. Or click Reports to order client-specific cost containment reports and network utilization reports.
• Descriptions of our broker incentive programs. Click Brokers to access the broker section of our Web site, then click Incentive Program to find out how you can qualify for our Broker Incentive Program and Broker Override Program.
  

Delta Dental Facts

Delta Dental Plan of New Jersey is part of a nationwide system of dental health service plans. Together, Delta Dental member Plans create the nation's largest, most experienced dental benefits carrier. Delta Dental offers employers, large and small, custom programs and reporting systems that provide employees with quality, cost effective dental benefit programs and services.

Statistics on Delta Dental's Health Care Leadership

• Delta Dental member Plans serve nearly one-quarter of the estimated 170 million Americans with dental insurance, providing dental coverage to over 42 million people in nearly 75,000 groups across the nation.
• Delta Dental's panel of dentists for its fee-for-service product is the country's most extensive. Delta Dental contracts with 107,883 dentists - or almost three out of every four U.S. dentists - in 134,490 locations. These practitioners are also part of DeltaUSA's (Delta Dental's National Accounts Program) fee-for-service product network - DeltaPremier USA.
• Delta Dental paid out an estimated $7.8 billion in claims during 2001.
• Delta Dental Plans posted approximately $8.8 billion in premium revenue during fiscal year 2001, the system's 22nd consecutive year of financial gains.
• In 2001, Delta Dental Plans processed nearly 56 million dental claims or nearly 1,077,000 every week, with an accuracy rate of 99 percent.
• Since 1954, Delta Dental has worked to improve oral health in the U.S. by emphasizing preventive care, and making dental coverage affordable to a wide variety of employers and groups.
• Delta Dental's unique cost control measures and contractual agreements with dentists help to ensure quality care at moderate fees, saving groups over $2.6 billion in 2001.

Delta Dental Products

Delta Dental Plans offer a variety of local programs that range from traditional fee-for-service and preferred-provider programs (PPOs) to dental health maintenance organizations (DHMOs) and Point-of-Service (POS), as well as customized programs as needed. Delta Dental also offers dental programs to national account groups. Through DeltaUSA, DDPA's national accounts program, Delta Dental Member Plans provide quality, uniform dental benefits programs to groups with a multi-state labor force. These products include:

• Managed fee-for-service products: DeltaPremier USA
• Dental preferred-provide organizations (PPOs): DeltaPreferred Option USA and (only in New Jersey) Delta's Advantage Program
• Dental health maintenance organizations (DHMOs): DeltaCare USA
• National voluntary group customers and Tricare (dental benefits program for uniformed military retirees and their families): DeltaSelect USA

DeltaUSA National Network Statistics

• As of December 2001, DeltaUSA provided dental benefits to over 6,000 groups with more than 6.1 million primary subscribers.
• As of September 2002, DeltaPreferred Option USA (Preferred Provider Option) has 44,363 contracted dentists practicing in 58,993 locations.
• As of August 2002, DeltaCare USA has 11,314 points of access with 8,073 contracted dentists.
• As of September 2002, DeltaPremier USA has 107,883 contracted practicing dentists in 134,490 office locations.

For more information about Delta Dental's services, contact our Marketing Department at 800-624-2633, or marketing@deltadentalnj.com.

Dentists Can Submit Claims to Delta Dental Via the Internet

Delta Dental Plan of New Jersey has rolled out a new service that will enable both participating and non-participating dentists to submit online claims directly to Delta Dental.

Online claims are faster and easier than paper claims for dental offices to submit, plus online claims are processed about 50% faster. "Delta Dental is committed to making it easy for dentists to work with us," said Bruce Silverman, senior vice president, Claims. "Programs like online claims submission help explain why almost three out of every four dentists nationwide are part of the Delta Dental network."

The online claims submission system has also been designed with patient privacy in mind. The confidential information we receive is not disclosed to other companies for marketing purposes, and eligibility and dental benefit information is released only to authorized individuals. Our site uses industry standards such as firewalls and Secure Socket Layer (SSL) technology to safeguard the confidentiality of personal information. It encrypts all personal information including Social Security numbers, name, and all plan coverage and benefit information. This means that unauthorized persons cannot read personal information displayed on our site as the information travels over the Internet. Any practicing dentist in the United States may use our online claims submission feature to submit claims for patients covered by Delta Dental Plan of New Jersey.

Value of Dental Benefits

Towers Perrin, one of the world's largest management and human resource consulting firms, recently conducted a study comparing the average cost increases for health plans and dental plans. They found that dental benefits costs are increasing at a much slower rate than health plan costs.

In the year 2000, the average cost increases for health plans were 10%, while the average cost increases for dental plans was 6%. In 2001, the average cost increases for health plans were 12% and the average cost increases for dental plans was 7%. In 2002, the average cost increases for health plans was 13%, and the average cost increases for dental plans was 6%.

This information was obtained from Towers Perrin Health Care Cost Survey based on active employees only.

Subscriber Satisfaction Survey Under Way

At this time Delta Dental is conducting its annual survey of subscribers. Brownstone Information Resources is administering the survey to a random sampling of subscribers. If your employees are contacted by Brownstone to participate, please urge them to complete the questionnaire and return it to Brownstone as soon as possible. Their feedback is critically important to us.

Survey results will be published in 2003. Thank you for your help!