Articles
Claims Inquiry Launches
2001 Annual Report Now Available
Donation Supports Paterson School District's Dental Assistant Training Program
HIPAA Privacy Provisions Under Review
Deadline for Transaction Compliance Extended... If You Apply
Mark These Important Dates!
New Dental Network Coordinator in Connecticut
Web Survey Results Announced
Congratulations Winners!
Claims Reminder
This Issue's Continuing Education Winners Announced!

Claims Inquiry Launches

Benefits Connection, Delta Dental's free online service that gives dentists and their patients easy online access to dental benefits information, has launched a new feature. Claims inquiry enables you to check the status of dental claims online.

The claims inquiry feature provides access to two years' worth of your patients' detailed Delta Dental claims history, including whether a claim is pending or has been paid, the amount and date paid, and details about procedures performed. You can also search claims history by tooth number or procedure code. You will also be able to read processing policies that were applied to any claims.

To access the claims inquiry feature, go to www.deltadentalnj.com, click on "Dentists," and log onto Benefits Connection. If you haven't yet registered for Benefits Connection, click "Register Now" in the Benefits Connection logon box and follow the online instructions. Please note that for security reasons there will be a 10-day delay for claims inquiry before your registration takes effect.

Benefits Connection* features include:

• An explanation of patient eligibility and coordination of benefits.
• Claims inquiry, so you can check the status of claims online.
• A description of your patients' Delta Dental plans.
• 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.

*Information contained in Benefits Connection is not a guarantee of benefits. All benefits are governed by the group contract and are subject to eligibility, maximums, deductibles, limitations, exclusions, waiting periods, and/or frequency limitations contained therein.

2001 Annual Report Now Available

This year's Annual Report highlights how Delta Dental is using Internet technology to make it easier for dentists, subscribers, brokers and benefits managers to do business with us. In 2001, Delta Dental launched "Benefits Connection," an online service that makes it possible for dental offices and subscribers to easily receive instant, detailed information about patients' Delta Dental benefits.

Other highlights of the 2001 Annual Report include:

• Achieving an impressive "AA-" Standard & Poor's rating of our financial strength for the second consecutive year.
• Adding close to 85,000 new subscribers, bringing our subscriber base to an all-time high.
• Details on the Foundation's extensive community outreach programs, which help deliver care to underserved populations, support dental education and research, raise public awareness, and assist worthwhile organizations.

To request a copy of the 2001 Annual Report, visit our Web site at www.deltadentalnj.com and click on "Our Company" on the navigation bar on the left side of the home page, or call Bea Buccos at 973-285-4201.

Donation Supports Paterson School District's Dental Assistant Training Program

The Delta Dental Plan of New Jersey Foundation recently donated $50,000 to help fund a new dental assistant training program at the Paterson School District's Health and Related Professions Academy (HARP).

"Delta Dental came to us with the possibility of start-up funding for our new vocational program, which is very unusual," says Maria Workman, RDH, MS, coordinator of Dental Services for the Paterson School District. "Having Delta Dental come forth to make this a reality was well beyond our expectations."

Delta Dental's donation was used to provide the classroom with a fully functioning dental operatory, which includes a dental chair, compressor, suction unit and dental instruments. Funds were also used to purchase computer stations, dental software, printers, scanners, educational videos, TV/VCRs, and other small dental lab materials necessary for the program.

"Community outreach is an integral part of our business operation," explained Walter VanBrunt, Delta Dental's President and CEO. "For this donation, we sought out a school district where funding was most needed and where it could have the greatest impact. Our financial commitment to the Paterson training program means that its students will have the resources they need to learn their trade and develop invaluable skills."

Delta Dental has made a further commitment to the Paterson School District by donating an ongoing yearly scholarship between $1,000-$1,500 to a graduating senior in the dental assistant program. The scholarship will be used to help the student complete his/her certification.

The main objective of the dental assistant program is to provide students with vocational classes that are linked to an American Dental Association (ADA) accredited post-secondary program. Students will earn high school credits, as well as credits that can be transferred to an accredited dental assistant program at the University of Medicine and Dentistry of New Jersey (UMDNJ). All classroom instruction will be conducted in the HARP Academy, while the practical applications will be done in the school's fully operations, four-chair dental clinic. Teachers who are adjunct professors at UMDNJ will instruct classes.

The HARP Academy is one of Paterson's six magnet schools. The dental assistant program will join the Academy's current curriculum, which includes a registered nurse assistant program and a pharmacy assistant program. All the programs are designed to provide students with skills that will make them employable as well as opportunities to reinforce those skills in a work environment.

The Paterson School District has a strong school-to-career program initiative and is dedicated to looking after the needs of its students. It is one of only a handful of districts that offers a comprehensive dental care clinic for those students who would not otherwise be able to afford care. The district found that dental health had an impact on learning, and that dental neglect played a large role in absenteeism. Based upon these findings, the district schedules dental visits four days each week from September through July, with more than 3,000 scheduled each year.

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 New Jersey.

HIPAA Privacy Provisions Under Review

The Health Insurance Portability and Accountability Act (HIPAA) requires healthcare plans, healthcare clearinghouses and healthcare providers (including dentists) who transmit electronic information in connection with standard transactions (covered providers) to establish standards that protect the privacy of individually identifiable health information (IIHI).

Since the Privacy Legislation was introduced, many covered entities have been asking Health and Human Services (HHS) to issue some clarifications regarding the rules details and intent. In March HHS (now known as CMS, Centers for Medicare & Medicaid Services) offered revisions to the Act's patient privacy rules. The largest area of proposed changes has to do with the issue of consent.

HIPAA originally required covered dentists to obtain consent from patients whenever they needed to use protected health information for treatment, payment or the dentist's healthcare operations. For example, a dentist would need to obtain a written consent from the patient in order to treat a patient or submit claims to Delta Dental.

The CMS revision said that healthcare providers shouldn't need to get permission to disclose patient information for routine matters such as treatment and payment. Instead, they propose replacing the required "consent" with a notice of a provider's privacy policy. Health and Human Services has indicated that it does not expect the modifications to the privacy rule to change the April 14, 2003 compliance date.

Delta Dental is continuing to participate in the process to develop the final HIPAA rules and will keep you informed.

Deadline for Transaction Compliance Extended... If You Apply

In addition to protecting patient privacy, HIPAA was also designed to encourage the efficient use of electronic data interchange (EDI) in health care. HIPAA calls for standardizing specific electronic transactions by requiring the use of certain formats and specified code sets.

All health plans, healthcare clearinghouses and healthcare providers - including dentists - who transmit certain health information in electronic form must comply with these new requirements of the EDI Rule. The deadline for compliance, originally set for October 16, 2002, has been extended to October 16, 2003, but only if a covered entity files a summary compliance plan with the Centers for Medicare & Medicaid Services (CMS).

To file the summary compliance plan online, go to www.cms.hhs.gov/hipaa/hipaa2/ascaform.asp. You may either file online or download a form to submit by mail. CMS states that completing the summary compliance plan should take about 15-20 minutes.

You will not receive a specific approval of your extension. Extensions are automatically granted, as long as you submit your summary compliance plan by October 15, 2002. More information about HIPAA is available at http://aspe.hhs.gov/admnsimp/.

Mark These Important Dates!

June 12-13, 2002
Delta Dental will be exhibiting at the New Jersey Dental Association annual meeting at booth #202 at the Taj Mahal in Atlantic City.

July 4, 2002
Delta Dental offices are closed for Independence Day, but our online Benefits Connection is ready to serve you all day, every day, even on weekends and holidays. Use Benefits Connection to answer questions about eligibility and benefits, determine maximum deductible balances, and more. You can even use Benefits Connection to check the status of your claims online. Benefits Connection is fast, easy to use and free. To access Benefits Connection, go to www.deltadentalnj.com and click on "Dentists."

September 25, 2002
Delta Dental's seminar series for dentists features Dr. Marvin Berman on pediatric dentistry. The seminar takes place at the Birchwood Manor in Whippany, New Jersey. All participating dentists will receive an invitation with details.

April 30, 2003
Delta Dental's seminar series for dentists features Dr. Stanley F. Malamed on "Drugs, Death and Dentistry." The seminar takes place at the Birchwood Manor in Whippany, New Jersey. All participating dentists will receive an invitation with details.

For more information about events sponsored by Delta Dental, visit our Web site at www.deltadentalnj.com, click on "Dentists" and then "Participation Information."

New Dental Network Coordinator in Connecticut

Delta Dental is pleased to welcome Kim Alberico as its new dental network coordinator in Connecticut. Her background includes more than 20 years of experience working in dental offices, where she was an assistant, with responsibilities for insurance, the front desk and office management. Most recently, Alberico traveled throughout the United States training dental office staffs how to use a dental management software program.

"I'm excited about the opportunity to work with dentists and their office staffs throughout Connecticut to help them make the most of their relationship with Delta Dental," says Alberico.

Delta Dental's Professional Services professionals are often the first point of contact between dental offices and Delta Dental. Dental network coordinators are available to provide answers and assistance about Delta Dental's policies and programs, including electronic claims processing, credentialing, Benefits Connection and our In-Net program, which offers discounts on products and services for dental practices.

Dental offices in Connecticut may contact Alberico at 888-396-6641 or 860-635-3152.

Web Survey Results Announced

Nearly 1,000 dentists participated in our recent survey in which we asked for your thoughts about Benefits Connection. Benefits Connection gives dentists online access to a patient's Delta Dental benefits information, including the ability to check the status of dental claims online.

Most specifically, we wanted to find out what features you would most like to see added to Benefits Connection. The No. 1 choice for the next Benefits Connection enhancement is claims submission.

"We developed this survey to make sure our initiatives were in line with the needs of dentists," says Diane Belle, assistant vice president, Corporate Communications and Internet project leader. "We have begun researching our options based on these findings."

The survey was mailed with the Explanation of Benefits statements during a two-week period in April. Approximately half of those surveyed reported that they visit Delta Dental's Web site (at www.deltadentalnj.com) and are registered Benefits Connection users.

Congratulations Winners!

Dr. William Derkasch, of Kenilworth, New Jersey, and Dr. Larisa Ilyutovich of Engelwood Cliffs, New Jersey, each received a $100 American Express gift cheque for participating in the Benefits Connection survey. Their names were randomly drawn from the nearly 1,000 dentists who completed the recent survey.

Delta Dental thanks everyone who participated in the survey.

Claims Reminder

Just a reminder to all dental offices when submitting crown and bridgework that benefits are payable only upon completion of the following services:

1. Cementation date of crowns/fixed partial dentures
2. Insertion date of removable prosthesis

A narrative is required if completed crowns or fixed partial dentures have the same date of service as a post and core or core buildup.

In addition, root canal therapy is payable after the procedure has been fully completed.

This Issue's Continuing Education Winners Announced

These are the latest winners of Delta Dental's yearlong program to promote continuing education for participating dentists. Before each issue of Dental News goes to press, we randomly select the names of 10 dentists - five from Connecticut, five from New Jersey - as winners.

Winners are eligible to receive up to $50 in tuition reimbursement from Delta Dental for attending a State Board of Dentistry-approved course on OSHA/infection control, CPR or Emergency Preparedness. In order to qualify for reimbursement, the course must relate to one of these topics. 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 any 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.