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Articles
Online Claims Submission Could Deliver
Cost Savings, Productivity Improvements to Your Practice
Four More Reasons to Submit Claims Online
Claims That You May Submit Online
Here's What Dental Offices Say About Online
Benefits Connection!
Compliance Initiatives Are in Full Swing at
Delta Dental
This Issue's Continuing Education Winners
Announced!
New Code Implementation
Re-credentialing Continues in CT
Hope to See You in NYC!
Tracey Bucher Named Customer Service Representative of the Year
X-ray Reminder
Online Claims Submission Could
Deliver Cost Savings, Productivity Improvements
to Your Practice
Delta Dental Plan of New Jersey plans to roll out
a new service this month that will enable both participating
and non-participating dentists to submit claims directly
to Delta Dental online, without going through a clearinghouse.
Why should your practice consider online claims
submission? It offers several advantages over paper
claims:
- Significant cost savings. The National
Dental EDI (Electronic Data Interchange) Council
estimates that the typical dental office that treats
35 patients a day saves more than $2,000 a year
using EDI instead of paper claims. While that savings
is significant, dental offices can save even more
by submitting claims directly to Delta Dental.
Routing claims through a clearinghouse network
can cost about 50 cents per claim to process. Online
claims submission to Delta Dental costs dental
offices nothing. For a dental office that sends
Delta Dental eight claims a day, online claims
submission would save it an additional $1,000 a
year, or about $3,000.
- Faster payment. Claims process about 50%
faster when they are submitted online.
- Ease of use. Submitting a claim to Delta
Dental online is a lot like submitting a paper
claim - except you don't need to worry about addressing
envelopes or buying stamps. From the moment you
log on, you're guided throughout the process.
- Improved accuracy of claims. The system
notifies users immediately if information is missing
or incorrect. Online claims submission prompts
you as you fill out the form.
To get started, go to Delta Dental's Web site at
www.deltadentalnj.com and click on Dentists on the
right side of the page. This takes you to the Dentists
section of our Web site. Log onto Benefits Connection.
(If you're unfamiliar with Benefits Connection or
are not registered for Benefits Connection, follow
the online directions to register.) Select Claims
Submissions and follow the step-by-step instructions
on the screen.
Any practicing dentist in the United States may
use our online claims submission feature to submit
claims to Delta Dental Plan of New Jersey for patients
covered by our Delta Dental Plan. We cannot accept
claims for patients covered by other Delta Dental
Plans. The service is available to both participating
and non-participating dentists.
For more information about our online claims submission
feature, visit our Web site at www.deltadentalnj.com,
click Dentists and log onto the Benefits Connection
Logon box. User Tips are available online.
Four More Reasons to Submit Claims
Online
Other benefits of Delta Dental's online claims submission
feature include:
- Expanded processing hours
Dental offices will be able to submit claims Monday
to Friday from 6 a.m. to 10 p.m. EST. This means
that most claims submitted during those hours
are processed immediately, in real time. Many
claims submitted during those hours will be immediately
adjudicated.
- Security and confidentiality of information
The system is password protected and secure. 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 number, name, and all plan coverage
and benefit information. This means that unauthorized
persons cannot read personal information as the
information travels over the Internet.
- Expedited processes for x-rays and attachments
Before submitting any x-ray or attachment, you
should always verify if they are required. Delta
Dental has taken steps to reduce the number of
x-rays and other attachments required when filing
claims. A complete list of procedures requiring
documentation is available on our Web site at
www.deltadentalnj.com; click Dentists on the
Delta Dental home page and then click Required
Documentation Charts. If documentation is required,
note the claim document number and mail the diagnostic
material to the special post-office box (the
address is provided on the screen). If you would
like to submit documentation electronically (including
x-rays, perio charting and narratives), please
contact NEA (National Electronic Attachment)
at 800-782-5150.
- Easy access to patient eligibility information
Dentists can easily check their patients' eligibility
online with Delta Dental's online Benefits Connection
feature. Dentists can first check their patients'
eligibility in Benefits Connection, and then
click over to online claims submission to submit
claims.
Claims That You May Submit Online
Practically every type of claim that you submit
by paper can now be submitted online, including:
- Claim with dated services; no Coordination of
Benefits (COB)
- COB with carrier other than Delta Dental Plan
of New Jersey (DDPNJ)
- COB with two or more Delta Dental Plan of New
Jersey coverages
- Pre-Treatment Estimate (PTE) for non-dated services
- Payment of a PTE (must have a PTE voucher number)
Here's What Dental Offices Say
About Online Benefits Connection!
It's never easy convincing people to try something
new, especially when it involves changing the way
they work. So, we knew some dental offices might
be a little hesitant about trying Delta Dental's
online Benefits Connection feature.
We were convinced that once dental offices tried
it, though, they would welcome its ease, convenience
and timesaving features. To check our assumptions, Dental
News recently asked several Benefits Connection
users in dental offices to talk about their experiences
using the feature. Here's what they said.
"I do not remember the exact date that I started
using Benefits Connection, but I have been using
it for quite some time now. I continue to use it
because it is a very easy way to find out patient
benefits and the status of claims without having
to wait on the telephone. I would recommend Benefits
Connection to anyone who has access to online usage.
I think it would save them time by using this feature." Marsha
Lee Gamba, Surgical Assistant for Lawrence P. Ryan,
DDS, MD
"Our practice started using Benefits Connection
six months ago for the convenience, and it's why
we continue to use it. I would recommend it." Sue
Beetar, Financial Coordinator, Aesthetic Family Dentistry
PA
"We started using Benefits Connection about
four months ago. It is faster and much more convenient
than verifying benefits over the phone. I can print
out all the information I need and file it in the
patient's chart. I can also go to whatever link I
need to go to rather than being transferred from
one person to the next. This goes for claim follow-up
as well." Lynne Tevere, Office Manager, East
Madison Dental/Dr. N. Jain
Benefits Connection features:
- 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.
Benefits Connection is available to both participating
and non-participating dentists. To access Benefits
Connection, go to www.deltadentalnj.com, click on
Dentists, and log on to 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.
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.
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 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,
extension 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 statements (EOBs) 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 guidance 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 Website 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 for the most up-to-date
information on our compliance efforts.
This Issue's Continuing Education
Winners Announced!
From Connecticut:
Dr. John Printup, Glastonbury
Dr. Paul Wineland, Milford
Dr. Irving Stanley, Storrs
Dr. Jeffrey Scull, Cromwell
Dr. Ira Greene, Avon
From New Jersey:
Dr. Neil Bryson, Colonia
Dr. Ira Zohn, Freehold
Dr. James Walter, Montville
Dr. Jeffrey Falduto, Lincoln Park
Dr. John Totera, Cliffside Park
These are the final winners of Delta Dental's yearlong
program to promote continuing education for participating
dentists. Before each issue of Dental News went
to press, we randomly selected 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 winning dentist
must attend the course; 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.
New Code Implementation
Effective January 1, 2003, dentists will be able
to submit CDT-4 codes to Delta Dental Plan of New
Jersey for claims processing. Acceptance of these
codes does not necessarily mean that they will be
benefited procedures. Chapter Nine of the Dentist
Handbook is being revised to reflect the new codes,
as well as Delta Dental's processing policies regarding
these codes. See pages 3 and 4 in this issue of Dental
News for an abbreviated fee filing form, which
you may fax to Delta Dental at 973-285-4140, or mail
to the address indicated on the form. Copies of the
form may also be downloaded from our Web site at
www.deltadentalnj.com; click on Forms on the left
navigation bar. You may direct questions regarding
filing the form to our Professional Relations Department
at 973-285-4163 or 973-285-4064.
Re-credentialing Continues in
CT
Re-credentialing of DeltaPremier and DeltaPreferred
Option dentists in Connecticut is ongoing. If you
are a DeltaPremier or DeltaPreferred Option dentist
in Connecticut, please update your credentialing
information as soon as possible. If you did not receive
a re-credentialing packet, or have questions about
re-credentialing, please contact our Credentialing
Department at 888-203-6993.
Hope to See You in NYC!
Delta Dental will be exhibiting at the Greater New
York Dental Meeting December 1-4, at the Jacob K.
Javits Convention Center in New York City. We will
be located at booth #630. Be sure to stop by to say
hello, and pick up information (and goodies) about
Delta Dental!
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.
X-ray Reminder
When submitting x-rays to Delta Dental, please remember
to include the subscriber's Social Security number
and patient's name along with your dental office's
name and address. This helps expedite claims processing,
especially if the x-rays become detached from the
claim form.
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