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Emergencies
& Encounters
What
to do if a Patient Requires Emergency Care from
a Specialist...
The
Encounter Form, or How to Make Sure Your Practice
is Getting the Most from the DeltaCare Plan
What
to do if a Patient Requires Emergency Care from
a Specialist...
Emergency Care
Process
Should a DeltaCare
patient require an immediate referral to a specialist
because of an acute condition, please proceed as
follows:
- Call a DeltaCare customer
service representative at 1-800-722-3524 (in
New Jersey) or 1-800-848-3524 (outside of New
Jersey).
- Provide the patient's name,
subscriber's social security number, the name
of the Flagship plan specialist to whom you are
referring the patient, and the nature of the
emergency.
- The DeltaCare customer
service representative will give you a six-digit
emergency authorization number to record on the
specialty referral form.
- The patient should be given
a copy of the form and any diagnostics, and would
then proceed to the specialist for emergency
treatment.
If an emergency
occurs after DeltaCare's normal business hours,
please refer the patient to a DeltaCare plan specialist
and contact DeltaCare on the next regular business
day to report the referral and obtain the emergency
authorization number.
The
Encounter Form, or How to Make Sure Your Practice
is Getting the Most from the DeltaCare Plan
Flagship Dental
Plans/DeltaCare requires the use of Encounter forms
for each patient visit. Your office can use DeltaCare
forms, or an ADA form is also acceptable. Each
time you send us an Encounter form, we record the
information into our system. The more information
we receive, the more accurately we can analyze
the relationships between member visits, procedures,
copayments, and capitation payments.
So... send in
those Encounters!
DeltaCare
is underwritten and administered by Flagship
Dental Plans, a wholly-owned subsidiary of
Delta Dental of New Jersey, Inc.
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