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Articles
Credentialing Begins in New Jersey
Things to Remember When Completing Credentialing
Paperwork
Y2K Transition Smooth
Delta Dental Helps Dentists ID Child Abuse
April is Child Abuse Prevention Month: What
You Can Do
Practice Wise: The Second Boom
How To Verify That Your Patient Is With Delta
Dental
PANDA Program Receives Honors
Credentialing Begins in New Jersey
All participating Delta Dental dentists in New
Jersey should have received a packet of information
in the mail recently about Delta Dental's credentialing
process. The credentialing questionnaire asks for
general office information and specific information
about your dental license(s), specialty certifications,
insurance coverage and infection control policies.
It also requires copies of documents such as your
dental license. If you did not receive a credentialing
packet, please contact our Credentialing Department
at (888) 203-6993.
You must complete and return your credentialing
survey within 30 days. Dentists who complete Delta
Dental's credentialing process will be eligible for
a special 10% premium discount (over and above other
available discounts) under the SAFECO Insurance Company
Preferred Dental Professional Liability Program.
For more information, visit www.safeco.com, or www.jamisongroup.com.
For a no-obligation estimate of the professional
liability coverage, call (800) 526-4766, ext. 352,
or e-mail lbarbaro@jamisongroup.com.
Delta Dental introduced credentialing in response
to a growing trend toward patient protection measures
at both the state and federal levels. This trend
is reflective of demands for increased accountability
regarding the administration of dental programs.
One key patient protection measure that helps provide
a response to these demands is the credentialing
of dentists who participate in the various types
of dental programs offered by insurers and other
third-party payers. Credentialing of dental networks
has become an important criterion when employer groups
are selecting an insurer or other organization to
provide dental coverage for their employees.
Things to Remember When Completing
Credentialing Paperwork
- If you participate in DeltaPreferred Option
or Delta's Advantage Program, you will receive
the credentialing packet for those programs and
not a separate DeltaPremier packet.
You will need to complete only one credentialing
form for the applicable program.
- If your office has multiple locations, be sure
to use the Multilocation Form, so you don't have
to repeat information on several forms.
- If you don't prescribe controlled substances,
please remember to initial the "drug attestation" portion
of the document.
- Be sure to include clean copies of requested
materials.
Y2K Transition Smooth
Delta Dental is pleased to let you know that we
enjoyed a successful Y2K transition. We would like
to thank you for putting your confidence in Delta
Dental. We are looking forward to working with you
in the 21st century.
Delta Dental Helps Dentists ID
Child Abuse
Each year, at least one million children nationwide
are physically, emotionally or sexually abused. The
actual number is probably much higher, says Sharon
Copeland, executive director of Prevent Child Abuse-New
Jersey, a private non-profit agency that develops
prevention programs for at-risk families.
"In New Jersey, we investigate child deaths, and
an average of one-third of those deaths are known
to the Division of Youth and Family Services (DYFS)," she
says. "That means a number of children died who weren't
known to DYFS, which leads us to believe there are
many instances where abuse is occurring and no one
reported it." Delta Dental Plan of New Jersey is
working to change that.
Through our philanthropic arm, the Delta Dental
Endowment Association, Delta Dental sponsors an educational
program for dentists called PANDA, for Prevent Abuse
and Neglect through Dental Awareness. PANDA is aimed
at helping dental office personnel recognize and
report suspected cases of child abuse and neglect.
"Dentists have a unique opportunity to see where
most child-abuse injuries occur, which are in the
head and neck region,"
says Dr. Lawrence Dobrin, a forensic dentist from
Roselle Park, New Jersey, and PANDA spokesperson. "We
have an opportunity to save a child with early intervention."
Many people, including dentists, are reluctant
to report suspected child abuse because they
are uncertain whether an injury resulted from
abuse or something else. "The unfortunate thing
is, unless you have some knowledge of or exposure
to what constitutes child abuse, it is difficult
to report or be suspicious," says Dr. Dobrin. "PANDA
shows dentists how to identify the difference
between accidental injuries and those inflicted
by a guardian or caretaker."
Thousands of dentists have attended
PANDA programs throughout New Jersey
and Connecticut. Programs are offered
several times a month, not only to dentists,
but also to school nurses, teachers and
other health-care providers.
"More dentists have begun reporting
child abuse since we started the PANDA
program," says Dr. Dobrin. "They know
where to report abuse and have less reluctance
once they have some training about what
constitutes child abuse."
While no one knows exactly how
many children have been rescued
because someone acted on information
learned from a PANDA program, Dr.
Dobrin is certain the program is
making a difference. "I've received
several calls over the years from
individuals thanking me because
the program made them comfortable
reporting child abuse. It made
them feel better that they could
do the right thing."
April is Child Abuse Prevention
Month: What You Can Do
- Wear a blue ribbon. Prevent Child Abuse-New
Jersey runs its Blue Ribbon campaign in April,
which Delta Dental supports. Last year it distributed
330,000 ribbons, which people wear throughout the
month to raise awareness of the problem. Each ribbon
comes with information on how to prevent child
abuse. For information, call (800) CHILDREN.
- Report suspected cases of abuse. In New Jersey,
contact your local DYFS District Office between
9 a.m. and 5 p.m. There is at least one District
Office in every county. After hours, the Office
of Child Abuse Control operates a toll-free hotline
round the clock, at (800) 792-8610. In Connecticut,
call the CARELINE at (800) 842-2288. Anyone who
reports abuse or neglect, or testifies in a child-abuse
hearing resulting from such a report, is immune
from any criminal or civil liability as a result.
Practice Wise: The Second Boom
With National Children's Dental Health Month recently
behind us, it brings to mind one question: Have you
noticed an increase in the number of children in
your practice? The census bureau tells us that in
1992 and 1993 the number of births in our country
exceeded those during the height of the "baby boom" in
the 1950s. What this means is that many of you are
now seeing more seven and eight year olds than ever
in your practice. This trend is likely to continue
as these children age.
With increased pediatric populations in
general practices several challenges occur:
- Increased demand for "peak hours" between 3:30
p.m. and 6:00 p.m.
- Increased cyclical production following school
and holiday cycles.
- Increased likelihood of last-minute cancellations
due to extra- curricular activity or illness. How
can we manage these challenges and continue to
have "prime time" blocks for adult patients that
wish to schedule after-work appointments? First,
you need to analyze procedure code data to determine
the number of children seen in the practice last
year. This will help you identify the need for
your office. Second, get creative in templating
your schedule, considering the focus and vision
of the practice. There are several ways to template
the schedule. Here are a few creative suggestions.
- Create kids days in your practice. These can
be fun, if you choose to make this a theme day
such as "superheroes"
"cartoon" or "sports" day. Staff can dress in costume.
Games and activities can be provided for children
in the reception area. Check with your local school
district to identify two school holidays or teacher
workdays approximately six to seven months apart.
Schedule all hygiene and doctor operatories with
children. Keep the doctor's schedule flexible so
that he or she can work in diagnosed treatment
from the hygiene department that day. This will
save the parent time and reduce anxiety for the
child.
- Encourage parents to bring children in during
school hours. One effective method of accomplishing
this is to let parents know you reserve "after
school time" for those children who are not doing
well in school. Naturally parents are proud of
their "A" student and want everyone to know. Help
them coordinate this with school lunch, physical
education, or art class.
- Template afternoon schedules in daily time blocks.
Determine the number of children appointment times
needed and focus time on a Tuesday and Thursday
perhaps. This will reserve Monday and Wednesday
for adult patients. This is a great way to reduce
the stress of switching gears from adult to pedo
mindsets on a daily basis.
- Introduce one Saturday per month or per quarter.
Analyze and track Saturday production carefully
to ensure profitability. Make this a fun day for
both staff and patients. Through careful analysis
of your practice demographics, you can successfully
blend these suggestions to suit your needs-and
possibly even increase your productivity and marketing
efforts.
What creative suggestions do you have? We'd love
to hear from you and pass this along to other readers.
Fax your ideas to (770) 512-0892 or email FPMVicki@compuserve.com.
Vicki McManus, RDH, is president of Fortune Practice
Management®, Connecticut. For more information
on consulting services or seminars, please call (888)
347-4785.
How To Verify That Your Patient
Is With Delta Dental
How can you confirm that your patient participates
with Delta Dental Plan of New Jersey? The quickest
and easiest way is to ask for the subscriber's Social
Security number, and then call our automated response
system at (800) 452-9310 for verification. Our automated
system can verify member eligibility for Delta Dental
Plan of New Jersey. Follow the prompts for a participating
dentist and for confirming eligibility. Your patient,
however, may participate in a Delta Dental Plan in
another state. In this case, you have two options
to verify eligibility:
- Call our Customer Service Department at (800)
452-9310, and press the star key (*) to speak to
a Customer Service agent (CSA). The CSA will ask
for the name of the patient's employer and whether
the employer is headquartered out of state. The
agent will then give you the phone number of the
correct Delta Dental Plan to call for verification.
- Call your patient's Delta Dental Plan directly.
Here is the current list of Delta Dental Plans
throughout the country and their addresses to send
claims:
- ALABAMA* - Send claims to: Delta Dental
Insurance Co.
- ALASKA* - Send claims to: Delta Dental
Insurance Co.
- ARIZONA - Delta Dental Plan of Arizona,
P.O. Box 43026, Phoenix, AZ 85080-3026, Phone:
800-352-6132
- ARKANSAS - Delta Dental Plan of Arkansas,
P.O. Box 16450 (Wal-Mart Only), P.O. Box 15965,
N. Little Rock, AR 72231, Phone: 800-462-5410
- CALIFORNIA - Delta Dental Plan of California,
P.O. Box 7736, San Francisco, CA 94120, Phone:
800-765-6003
- COLORADO - Delta Dental Plan of Colorado
P.O. Box 173803, Denver, CO 80217, Phone: 800-233-0860
- CONNECTICUT - Send claims to: Delta
Dental Plan of New Jersey
- DELAWARE - Send claims to: Delta Dental
of Pennsylvania
- DISTRICT OF COLUMBIA - Send claims to:
Delta Dental of Pennsylvania
- FLORIDA* - Send claims to: Delta Dental
Insurance Co.
- GEORGIA* - Send claims to: Delta Dental
Insurance Co.
- HAWAII - Hawaii Dental Service, 700
Bishop Street, 7th Floor, Honolulu, HI 96813-4196,
Phone: 808-521-1431 ext. 248
- IDAHO - Delta Dental Plan of Idaho,
P.O. Box 2870, Boise, ID 83701, Phone: 800-388-3490
- ILLINOIS - Delta Dental Plan of Illinois,
P.O. Box 9150 (DeltaUSA), Downers Grove, IL 60515,
Phone: 800-452-1987
- INDIANA - Delta Dental Plan of Indiana,
Send claims to: Delta Dental Plan of Michigan
- IOWA - Delta Dental Plan of Iowa, 2401
S.E. Tones Drive, Suite 13, Ankeny, IA 50021,
Phone: 800-532-1514
- KANSAS - Delta Dental Plan of Kansas,
P.O. Box 49198, Wichita, KS 67201-9198, Phone:
800-234-3375
- KENTUCKY - Delta Dental Plan of Kentucky,
P.O. Box 242810, Louisville, KY 40224-2810, Phone:
800-955-2030
- LOUISIANA* - Send claims to: Delta Dental
Insurance Co.
- MAINE** - Send claims to: Northeast
Delta Dental
- MARYLAND - Send claims to: Delta Dental
of Pennsylvania
- MASSACHUSETTS - Delta Dental Plan of
Massachusetts, P.O. Box 9695, Boston, MA 02114,
Phone: 800-872-0500
- MICHIGAN - Delta Dental Plan of Michigan,
P.O. Box 9085, Farmington Hills, MI 48333-9085,
Phone: 800-524-0149
- MINNESOTA - Delta Dental Plan of Minnesota,
National DeltaUSA, P.O. Box 59238, Minneapolis,
MN 55459-0238, Phone: 800-448-3815
- MISSISSIPPI* - Send claims to: Delta
Dental Insurance Co.
- MISSOURI - Delta Dental Plan of Missouri,
12399 Gravois Road, St. Louis, MO 63127-1167,
Phone: 800-392-1167
- MONTANA* - Send claims to: Delta Dental
Insurance Co.
- NEBRASKA - P.O. Box 245, Minneapolis,
MN 55440, Phone: 800-736-0710
- NEVADA* - Send claims to: Delta Dental
Insurance Co.
- NEW HAMPSHIRE** - Send claims to: Northeast
Delta Dental
- NEW JERSEY - Delta Dental Plan of New
Jersey, P.O. Box 222, Parsippany, NJ 07054, Phone:
800-452-9310
- NEW MEXICO - Delta Dental Plan of New
Mexico, 2500 Louisiana Blvd., N.E., Suite 600,
Albuquerque, NM 87110, Phone: 800-999-0963
- NEW YORK - Send claims to: Delta Dental
of Pennsylvania
- NORTH CAROLINA - Delta Dental Plan of
North Carolina, 333 Six Forks Road, Suite 180,
Raleigh, NC 27609, Phone: 800-662-8856
- NORTH DAKOTA - Send claims to: Delta
Dental Plan of Minnesota
- OHIO - Delta Dental Plan of Ohio, Send
claims to: Delta Dental Plan of Michigan, Phone:
800-524-0149
- OKLAHOMA - Delta Dental Plan of Oklahoma,
The Broadway Plaza, 16 Northwest 63rd St., 3rd
Floor, Oklahoma City, OK 73116, Phone: 800-990-7337
- OREGON - ODS Health Plan, 315 S.W. 5th
Avenue., #1100, Portland, OR 97204, Phone: 800-243-4494
(OR only) 800-452-1058 (out of state)
- PENNSYLVANIA - Delta Dental of Pennsylvania,
One Delta Drive, Mechanicsburg, PA 17055, Phone:
800-932-0783
- RHODE ISLAND - Delta Dental of Rhode
Island, P.O. Box 1517, Providence, RI 02901-1517,
Phone: 800-843-3582
- SOUTH CAROLINA - Send claims to: Delta
Dental Plan of Missouri
- SOUTH DAKOTA - Delta Dental Plan of
South Dakota, P.O. Box 1157, Pierre, SD 57501,
Phone: 800-627-3961
- TENNESSEE - Delta Dental Plan of Tennessee,
240 Venture Circle, Nashville, TN 37228, Phone:
800-223-3104
- TEXAS* - Send claims to: Delta Dental
Insurance Co.
- UTAH* - Send claims to: Delta Dental
Insurance Co.
- VERMONT** - Send claims to: Northeast
Delta Dental
- VIRGINIA - Delta Dental Plan of Virginia,
4818 Starkey Road, S.W., Roanoake, VA 24014,
Phone: 800-367-3531
- WASHINGTON - Washington Dental Service,
P.O. Box 75688, Seattle, WA 98125, Phone: 888-596-4007
- WEST VIRGINIA - Send claims to: Delta
Dental of Pennsylvania
- WISCONSIN - Delta Dental Plan of Wisconsin,
P.O. Box 828, Stevens Point, WI 54481, Phone:
800-236-3713
- WYOMING - Delta Dental Plan of Wyoming,
320 W. 25th St., Suite 301, Cheyenne, WY 82001,
Phone: 800-735-3379
*Delta Dental Insurance Company (DDIC) -
P.O. Box 1809, Alpharetta, GA 30023, Phone: 800-521-2651
**Northeast Delta Dental - P.O. Box 2002, Concord,
NH 03302-2002, Phone: 800-537-1715
PANDA Program Receives Honors
The Points of Light Foundation named Delta Dental
Endowment Association's PANDA program a Citationist
in the 1999 President's Service Awards program, presented
by the Points of Light Foundation.
"The problems of our communities and of our nation
have become so great and so pervasive that it is
only with the efforts of dedicated citizens like
you and those with whom you work that we can begin
to address them successfully,"
wrote Robert Goodwin, President and Chief Executive
Officer of the Points of Light Foundation, to Diane
Belle, Delta Dental Assistant Vice President.
The PANDA Program was selected for Citation recognition
from among 3,500 nominations.
Thank You, EDI Survey Respondents!
In October, we asked 3,000 dental offices who electronically
submit claims to Delta Dental to complete a brief
survey regarding the Year 2000 compliance of their
practice management software. Nearly half of those
dental offices responded.
"Your efforts helped us determine the potential impact
of Y2K on claims processing and enabled us to deliver
our continued high level of service," says Beth DeCapio,
EDI Coordinator.
"Thanks to all who participated."
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