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Articles
Benefits Connection Makes It Easy to
Access Patients' Dental Benefits Information
FAQ: What is Delta Dental's COB Credit Reserve
Policy?
In-Net Program Offers Wireless Discounts
CT Re-Credentialing Began in January
Welcome New Groups
Delta Dental Launches Web Site Improvements
Sign Our Guestbook for Regular Updates
Delta Dental Partners with Matheny School
and Hospital and UMDNJ-School of Dentistry to Establish
a Dental Clinic for People with Disabilities
Congratulations to Desiree Fusco!
Benefits Connection Features
Congratulations Winners of Education Program
What NJ Prompt Pay Law Means to You
Register Now for Delta Dental Classic
UMDNJ Scholarship Fund Honors Delta Dental
Prevent Child Abuse-New Jersey Honors Delta Dental
How to Appeal a Benefits Determination
Hamilton Dentist Uses In-Net Benefit to Save on Dental Supplies
Benefits Connection Makes It
Easy to Access Patients' Dental Benefits Information
Benefits Connection is now the fastest, easiest
way for dentists to obtain instant, detailed information
about their patients' Delta Dental benefits. The
online service is free. When you use Benefits Connection,
you no longer need to call Customer Service to determine
a patient's eligibility. You can find the answer
in less than 30 seconds (any time of the day or night),
using a standard browser such as Internet Explorer
or Netscape and an Internet connection.
Plus, the system is so user-friendly that it even
tells you what to do if you encounter a problem.
Please see page 5 for a brief rundown of how to use
Benefits Connection and its benefits to your dental
practice. Look inside on page 3 for more information
on our Web site features.
FAQ: What is Delta Dental's COB
Credit Reserve Policy?
On any coordination of benefits (COB) secondary
case where Delta Dental pays less than what we would
have paid in the absence of COB, the savings are
put in reserve for each individual patient. For any
future claims submitted within the calendar year
for that individual, Delta Dental will pay any patient
out-of-pocket expenses from the accumulated credit
reserve, not to exceed the amount in the reserve.
In-Net Program Offers Wireless
Discounts
Looking for an easy way to reduce your wireless
telephone bill? Delta Dental's In-Net Program now
offers a program that delivers wireless-service discounts
to participating dentists. The program, developed
by Delta Dental and Sprint PCS and administered by
Wireless America, provides a 5% discount on wireless
telephone service, as well as discounts of up to
50% on wireless accessories. In addition, participating
dentists will receive a free car adapter AND either
a leather case or hands-free headset with each new
activation. For more information, contact your dental
network coordinator at 888-396-6641. To enroll, contact
Wireless America at 888-655-4727, ext. 123, or via
e-mail at tonyg@wirelessamerica.com.
CT Re-Credentialing Began in
January
Three years ago, Delta Dental launched its dentist
credentialing program in Connecticut and required
all participating dentists to become credentialed.
We successfully credentialed 100% of all participating
dentists in our DeltaPremier and DeltaPreferred Option
programs.
Now it's time for participating dentists in Connecticut
to update their credentials. All participating DeltaPreferred
Option dentists in Connecticut should have received
a re-credentialing packet in January. (DeltaPremier
dentists in Connecticut should receive packets in
the next few months.) The packet will allow dentists
to easily update their credentialing information.
The re-credentialing form is pre-filled with the
responses provided during the original credentialing
process. Dentists can make any applicable changes
on the form itself. For your convenience, submit
only copies of credentials (such as DEA, license,
CSC) whose expiration date as listed on the credentialing
form has been exceeded.
We also require dentists to submit a copy of their
current dental malpractice insurance binder page.
The minimum coverage required is $1 million/$3 million.
Delta Dental appreciates your prompt response. Dentist
credentialing assures our employer groups that each
Delta Dental participating dentist meets or exceeds
the criteria to join our network. If you are a participating
DeltaPreferred Option dentist in Connecticut and
did not receive your re-credentialing packet or have
questions about re-credentialing, please call our
credentialing unit at 888-203-6993.
Re-credentialing will take place every three years.
Welcome New Groups
Delta Dental would like to welcome these groups
as of January 2002:
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| Alvin
& Company |
L.
P. Thebault Company |
| Ashforth
Company |
Lonza
Biologics, Inc. |
| Biersdorf,
Inc. |
Lonza,
Inc. |
| Birdsall
Engineering, Inc. |
Mediq/PRN
Life Support |
| Brother
International |
Middlesex
Health System |
| CCL
Container |
New
Britain General Hospital |
| Connecticut
State Teacher's Retirement Board |
New
England Motor Freight |
| Crane
Company |
Novametrix
Medical Systems |
| Curtis-Wright
Corporation |
OCI
Chemical Corporation |
| Dataram
Corporation |
Pharmacia
Corporation |
| Duferco
Steel |
PTA
Corporation |
| Evesham
Township |
Regional
Water Authority |
| Family
Meds |
Roche
Diagnostics Corporation |
| Food
Circus Supermarket, Inc. |
Sands
Hotel & Casino |
| Footstar,
Inc. |
Sun
Bancorp |
| Goebel
Marketing Corporation |
The
Seimon Company |
| Gund,
Inc. |
Valley
Health System |
| Hermann
Services |
Virtua
Health System |
| Hexcel
Corporation |
VNA
Health Care, Inc. |
| Hunter
Douglas, Inc. |
Voltarc
Technologies, Inc. |
| Imagistics
International |
|
Delta Dental Launches Web Site
Improvements
Delta Dental's Web site, at www.deltadentalnj.com,
unveiled a new look in January. The redesigned site
makes it easier than ever to find the information
you need. The navigation bar on the left-hand side
of the home page prominently highlights important
features such as:
- "Find a Dentist," which enables subscribers
to find a participating dentist in their area,
check to see if their dentist is a participating
dentist, and find directions to the dental office.
- "Products," which describes the various
Delta Dental programs in detail.
- "Forms," where you can download claim
forms and other documents.
To find information specific for dental offices,
click on
"Dentists" on the right-hand side of the
Delta Dental home page. This will take you to a home
page designed for you. Some of the information you
can access includes:
- "Benefits Connection," the new online
service that enables dentists to verify their patients'
benefits.
- Listings and registration information for professional
development programs.
- Claims information, including diagnostic guidelines,
processing policies, and review and appeals procedures.
- Information on how to start submitting electronic
claims.
- Information on how to become a participating
dentist, and the benefits of participation (such
as our In-Net Program).
- Listings of key contacts, such as dental network
coordinators and Customer Service
If you have trouble locating the information you
need, click on "Site Map" at the top of
the Delta Dental home page to see the contents of
the entire site at a glance. Or, go to the "Search" box
next to the
"Site Map" and type in what you're looking
for.
Watch for claims inquiry, which should become available
within the next few months.
Sign Our Guestbook for Regular
Updates
Delta Dental can deliver information on a variety
of subjects right to your e-mail inbox! To sign up
for this service, just visit our Web site at www.deltadentalnj.com,
and click on "Guestbook" on the left side
of the Home page screen. You can request immediate
information on topics such as:
- Benefits and services for participating dentists
- PANDA
- Electronic claims
Once you register, you will receive periodic updates
in your e-mail inbox on the topics you selected.
It's the easiest way for your dental office to stay
up to date about what's happening at Delta Dental
that affects you!
Please note: We do not sell, rent, or disclose your
e-mail address to third parties. Therefore, you will
not receive unsolicited e-mail ("spam")
as a result of signing our Guestbook.
Delta Dental Partners with Matheny
School and Hospital and UMDNJ-School of Dentistry
to Establish a Dental Clinic for People with Disabilities
Delta Dental's Foundation recently made a donation
to the Matheny School and Hospital that will be used
to staff and equip three dental offices in Matheny's
new, state-of-the-art medical and dental facility.
The donation was made to Matheny, a teaching facility
for people of all ages with developmental disabilities,
as part of Delta Dental's initiative to provide funds
to organizations that assist those without access
to traditional dental care. Matheny, located in Peapack,
New Jersey, specializes in the care of individuals
with physical disabilities such as cerebral palsy,
muscular dystrophy, spina bifida, and Lesch-Nyhan
disease. Five years ago, Matheny received an exploratory
grant from Delta Dental to evaluate and provide a
means of dealing with the orthodontic needs of its
residents. In reviewing the situation, Matheny's
directors realized that there was a greater need
for general dentistry services, including cleanings
and fillings. They also determined that there's an
overall shortage of dentists trained and skilled
in working with physically handicapped patients.
To address these issues, Delta Dental and UMDNJ-New
Jersey Dental School joined forces with Matheny to
create a facility that will care for this special
population and also serve as an on-site teaching
clinic. Delta Dental's donation will provide the
three new dental offices with instruments to accommodate
residents' physical handicaps, such as tilting devices
for wheelchairs. The facility, which will be staffed
by UMDNJ-New Jersey Dental School faculty, will also
be a learning center for dental students currently
in the residency phase of schooling.
"Through our partnership with Matheny, physically-handicapped
patients will now be able to receive much needed
care from specially-trained dentists," said
Dr. Gerald Sydell, Chairman, Delta Dental Plan of
New Jersey and Vice President, Delta Dental Foundation,
Inc.
"Since the Foundation also endeavors to assist
in educational pursuits of those interested in dentistry,
it is especially meaningful to us that the clinic
will also be a training facility for students to
learn valuable, specialized skills that are so desperately
needed in our field."
In December, Matheny began renovation of a
wing in the hospital that will house the new
medical and dental facility. The wind will
ultimately include a waiting area, medical
records area, and examination/treatment rooms.
It is scheduled to open this year.
Matheny is a nonprofit organization
that receives state, federal, and local
funding as well as grants and private
donations. It currently provides residential,
inpatient and outpatient service to over
650 clients and their families. Services
are available on a residential or an
outpatient basis. Its mission is to provide
people with habilitative services and
to assist them in the attainment of their
optimal level of functioning. In addition,
the organization engages in professional
activities including, but not limited
to, research, development, and the dissemination
of information.
Delta Dental established the Delta Dental
Plan of New Jersey Foundation in 1986.
Its mission includes promoting and assisting
educational projects devoted to the enhancement
of dental health, research programs designed
to increase public awareness of the general
benefits of good health, and to improve
dental health through the science of
dentistry. Each year, the Delta Dental
Foundation provides financial support
to various organizations throughout the
state.
Congratulations to Desiree Fusco!
Desiree Fusco, formerly our Dental Network Coordinator
in Connecticut, recently won two gold awards for
network recruitment achievement at the Delta Dental
Plans Association Professional Relations seminar
in Miami, Florida. Desiree received two plaques and
a $1,000 gift certificate to Marshall Fields.
Fusco, who joined Delta Dental in May 2000, recently
moved to our Marketing Department as an account executive.
Benefits Connection Features
Congratulations Winners of Education
Program
| From
Connecticut: |
From
New Jersey: |
| Dr.
Dale Roberts, Enfield |
Dr.
Dominick Ianora, Bayonne |
| Dr.
Gary Rothrock, Stratford |
Dr.
Joseph Wallace, Bound Brook |
| Dr.
Randy Gordon, West Hartford |
Dr.
Robert Greenman, Lakewood |
| Dr.
Allan Phillips, Ridgefield |
Dr.
Lawrence Collins, Ocean |
| Dr.
Bruce Soloff, Stamford |
Dr.
Donald Shima, Tenafly |
These 10 participating dentists are the first group
of winners in Delta Dental's year-long program to
promote continuing education. Throughout 2002, each
issue of Dental News will announce the names of 10
randomly selected participating dentists, five from
New Jersey and five from Connecticut. If your name
is selected, you will be eligible to receive up to
$50 in tuition reimbursement from Delta Dental for
attending a State Board of Dentistry-approved course
on one of the following topics:
- OSHA/Infection Control
- CPR
- Emergency Preparedness
"The program benefits participating dentists,
their patients and Delta Dental," says Dr. Scott
Navarro, Delta Dental Vice President, Professional
Services and Dental Director. "It supports participating
dentists in their effort to stay up to date on topics
that are an essential part of Delta Dental's credentialing
standards. These topics also have a direct benefit
on their patients, as well."
In order to qualify for reimbursement, the course
must relate to OSHA/infection control, CPR or emergency
preparedness. Also, the course must be attended by
the winning dentist; colleagues and members of the
office staff are not eligible.
To receive tuition reimbursement, the winning dentist
should fax a certificate of completion for the OSHA/infection
control, CPR or emergency preparedness course to
Delta Dental's Professional Relations Department
at 973-285-4140. Winning dentists have one year from
the time their names are announced to take the course
and fax their certificates of completion.
If you have questions, please contact your dental
network coordinator at 888-396-6641. Ten more winners
will be named in the next issue of Dental News. Sixty
winners in all will be selected in 2002.
What NJ Prompt Pay Law Means
to You
New Jersey's Prompt Pay Law requires Delta Dental
to make a good faith effort to obtain any missing
information and diagnostics that are necessary to
process a claim before sending a letter. Under the
requirements of the law, Delta Dental must first
contact dental offices by phone, fax or e-mail about
the missing information. After contacting the dental
office by phone, fax or e-mail, Delta Dental will,
if necessary, send a follow-up letter or Explanation
of Benefits, which details what information is missing.
Please note that you don't need to wait for the
follow-up letter or Explanation of Benefits before
sending missing diagnostics or other information
necessary for processing a claim. You may send that
information at any time. Be sure all diagnostics
or other information are clearly labeled with the
date, patient name, the dentist's name and address,
and the claim number for identification purposes.
The claim number will be provided when we contact
you by phone, fax or e-mail.
To avoid most missing information delays, be sure
claim forms are fully completed and necessary attachments
are included on all claim submissions. Refer to Chapter
4 of your Dentist Handbook. Or visit our Web site
at www.deltadentalnj.com. For form completion instructions,
click "Forms" in the navigation box on
the left side of the screen, and select "Claim
Form."
Instructions can be found on the second page of the
Dental Claim Form. For Diagnostic Guidelines, click
"Dentists," then select "Claims Information" and
then "Diagnostic Guidelines."
Register Now for Delta Dental
Classic
It may still be the middle of winter, but the Twelfth
Annual Delta Dental Classic will be here before you
know it. The annual golf event and dinner, which
benefit Special Olympics New Jersey, will take place
Tuesday, June 4, at the Cherry Valley Country Club
in Skillman, New Jersey.
Brochures and registration information were mailed
in January to past participants. If you did not receive
a brochure, please contact Jennifer Appaluccio at
973-285-4059 to request a copy.
Registration is accommodated on a first come, first-served
basis. Last year's event drew 126 participants and
raised $50,000 for Special Olympics New Jersey, increasing
the event's lifetime total to more than $300,000.
We hope you'll join us for a great day to benefit
a worthy cause!
UMDNJ Scholarship Fund Honors
Delta Dental
The Dental Alumni Scholarship Fund of UMDNJ-New
Jersey Dental School honored Dr. Gerald Sydell, Delta
Dental's Chairman of the Board, and Walter VanBrunt,
President and CEO. They were recognized at the scholarship
fund's
"Coming Together" dinner on November 2,
2001 for their support of the New Jersey Dental School.
Delta Dental has provided scholarships for dental
students, as well as dental hygiene and assisting
students; equipment for training and research; and
continuing education for dental professionals.
Prevent Child Abuse-New Jersey
Honors Delta Dental
Delta Dental was named Corporate Honoree by Prevent
Child Abuse-New Jersey at its 7th annual dinner November
1 in Princeton.
Delta Dental has been a longtime supporter of Prevent
Child Abuse-New Jersey's Blue Ribbon Campaign, which
takes place every April to raise funds and educate
people about child abuse. In addition, Delta Dental's
PANDA (Prevent Abuse and Neglect through Dental Awareness)
Program teaches dentists how to identify signs of
child abuse and take appropriate action.
"Being new to the Prevent Child Abuse-New Jersey
organization, I continue to be pleasantly surprised
at the number of partners from the private sector
working to prevent child abuse," says PCA-NJ's
new Executive Director, Janet F. Rosenzweig, Ph.D. "Delta
Dental's PANDA program is an outstanding example
of child-abuse prevention through professional education,
and PCA-NJ is proud to be associated with it."
Others honored at the dinner were John Sakson, Esq.
(Man of the Year) and Jeannine LaRue (Woman of the
Year).
Prevent Child Abuse-New Jersey was founded in 1979
as a private, non-profit organization committed to
preventing child abuse. PCA-NJ leads statewide efforts
to eliminate child abuse in all its forms. PCA-NJ's
programs are implemented in collaboration with schools,
health care organizations and community-based agencies
across New Jersey.
How to Appeal a Benefits Determination
Participating Delta Dental dentists can request
a review of any benefits determination by writing
to:
Delta Dental Plan of New Jersey
Attention: Director, Customer Service
Request for Review
P.O. Box 222
Parsippany, New Jersey 07054
These requests may also be faxed to 973-285-4141.
Formal appeals by dentists who participate with Delta
Dental Plan of New Jersey can be made according to
the procedures outlined in Delta Dental's Participating
Dentist Rules and Regulations, located in the Participating
Dentist Handbook. These policies may also be found
at www.deltadentalnj.com.
Hamilton Dentist Uses In-Net
Benefit to Save on Dental Supplies
Dr. Stan Rauchwerger, a dentist in Hamilton Township,
New Jersey, would rather pay less than more for the
same item, as we all would. "I like to make
sound business decisions," he explains. It's
why he joined the Delta Dental network shortly after
starting his practice 21 years ago, and why he still
participates today. It's also why he used Profit
Finder, a price-comparison shopping service that
provides a reduced membership fee to participating
Delta Dental dentists. "With Profit Finder,
I save 25 percent to 30 percent on all my dental
supplies," says Dr. Rauchwerger. "With
those savings, I can afford to pay my staff more."
Profit Finder is one of many benefits Delta Dental
offers to participating dentists through its In-Net
Program. The In-Net Program provides discounts on
many items a dental practice may need, including
dental supplies and equipment, practice management
software and hardware, mobile telephone service and
even a free Internet home page. Profit Finder surveys
dental supply companies throughout the country to
find the best available prices on name brand and
generic dental products and equipment. "Our
suppliers will usually match or come close to the
best available prices listed in Profit Finder," says
Dr. Rauchwerger.
"In some cases we also use Profit Finder's master
suppliers." Since he started using Profit Finder
several years ago, Dr. Rauchwerger has always been
able to find the supplies and equipment he needed
in Profit Finder's database.
If you want to save money on supplies, Profit Finder
is an easy way to do it," says Dr. Rauchwerger.
"There's nothing to lose." For more information
on Delta Dental's In-Net Program, visit Delta Dental's
Web site at www.deltadentalnj.com, and click on "In-Net
Program" under Participation Information in
the Dentists section, or call your dental network
coordinator at 888-396-6641. To enroll in Profit
Finder, call 800-443-5095 or visit their Web site
at www.profitfinder.com.
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