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Articles
Reach More Potential Patients by Joining
Delta Dental Patient Direct Network
Hook Kids on Oral Health During National Children's Dental Health Month
Implants Processing Policy Reminder
If Your Degree is DDS, Please Let Us Know
NEA Offers Discount on Electronic Attachments
Fees Updated for Delta Dental PPO, Delta Dental
Patient Direct
Foundation Helps Underserved Access Dental Care
Be Sure to Disclose All Patient Discounts on
Claim Forms
Golfers, Mark Your Calendars for June's Golf
Classic
Programs Help Smokers Quit Habit
Reach More Potential Patients
by Joining Delta Dental Patient Direct Network
We think our
dental plans are the best in the business, and
so do the many people in New Jersey with Delta
Dental coverage.
Unfortunately,
many New Jersey residents don’t have dental
insurance. They may be retired, self-employed,
or working at jobs not covered by a dental plan.
We recently
introduced a program to give New Jersey’s
uninsured access to dental care. Delta Dental Patient
Direct is a dental membership program. Members
pay a small yearly fee. For that, they have access
to more than 1700 New Jersey dentists who limit
fees to those in the Delta Dental Patient Direct
fee schedule.
So, why should
you join?
- It broadens
your patient base. Members use the “Find
a Dentist”
feature on our Web site to find a participating
Patient Direct dentist near them.
- You
can better accommodate patients without employer-sponsored
dental coverage. Many people without dental
coverage postpone dental care. Because Patient
Direct members know how much their treatment
will cost, they can better budget for it.
- Patients
pay you directly. Since Delta Dental Patient
Direct is not insurance, there are no forms
to submit, waiting periods, annual maximums,
deductibles or copayments. Patients pay you
at the time of service, so there is no waiting
for payment.
- The
fee schedule is win-win for you and your patients. The
Patient Direct fee schedule is the same as
our Delta Dental PPO fee schedule. Patient
Direct members benefit because they pay these
negotiated fees. You receive the same amount
as you do as a participating Delta Dental PPO
dentist.
- You’re
promoting better oral health to more people. The
Patient Direct program encourages people without
dental insurance to visit their dentists regularly
and look after their oral health.
The Delta
Dental Patient Direct network is open to participating
Delta Dental PPO dentists and Delta Dental Premier
specialists in New Jersey. (There is a separate
fee schedule for Delta Dental Patient Direct network
specialists.) For more information on the benefits
of joining the Delta Dental Patient Direct network,
contact your dental network coordinator at (888)
396-6641.
Also, if you have patients without dental insurance,
please let them know about Delta Dental Patient Direct.
They can call (877) TOOTH-07 or visit the Delta Dental
Patient Direct Web site at www.patientdirectnj.com
for more information or to join.
Hook Kids on Oral Health During
National Children's Dental Health Month
Kids don’t
always eat right, brush or floss. But if they develop
those habits now, they’re more likely to
enjoy good oral health long into adulthood.
February is
National Children’s Dental Health Month.
The American Dental Association (ADA) offers free
resources so dentists can get the message out to
kids.
If you’re
speaking at a school or youth group: The
ADA has many presentation resources for audiences
from kindergarten age to grade 12. They include
presentation outlines, activities and guidance
on what interests children in each age group.
If your
office is celebrating National Children’s
Dental Health Month: You can download free
coloring pages and activity sheets for children
at the ADA Web site. Children can learn while
they play, waiting for their dental appointment.
Go to the
ADA’s Web site at www.ada.org and click “National
Children’s Dental Health Month.”
We’re
also celebrating National Children’s Dental
Heath Month. The Delta Dental Foundation sends
Captain Supertooth to dozens of schools in New
Jersey and Connecticut every February to get students
excited about oral health.
Captain Supertooth
is a caped superhero who teaches kids how to fight
against tartar, gingivitis and cavities. Using
a giant red toothbrush and the children as teeth,
Captain Supertooth shows children how to brush
and floss. He also talks about how a balanced diet
and regular dental visits keep teeth healthy.
Judging by
their letters, children love Captain Supertooth’s
lesson.
“Thank
you Captain Supertooth. I learned from
you to always brush my teeth. I learned to eat
healthy food. You are excellent Captain Supertooth,” wrote
Marshall.
“Dear
Captain Supertooth, Thank you for coming to our
school. You are cool!” wrote Kenny, “the
kid who was missing 4 teeth.”
Because Captain
Supertooth is in such high demand, we also developed
a Captain Supertooth video, which is free to schools
and available in both English and Spanish.
Implants Processing Policy Reminder
Delta Dental
processes payment for implants and procedures related
to implants according to the terms of the client's
contract. Depending on the contract, the implants
may be payable, not covered, or have an alternate
benefit applied to them. A pre-treatment estimate
is always recommended before performing these services.
If Your Degree is DDS, Please
Let Us Know
The Delta
Dental Plans Association is updating its database
of participating and non-participating dentists.
The database added a new field for dentist degrees:
DDS or DMD.
Delta Dental
of New Jersey is using the DMD degree as the default
field. If you have a DMD degree, you don’t
need to do anything.
If you have
a DDS degree, please let us know by using the handy
fax-back form below. This will ensure that your
degree information is accurate in DDPA directories,
our online “Find a Dentist”
feature and any communications we have with you.
Fax the completed form to (973) 285-4192. If you
have questions, please contact your Dental Network
Coordinator at (888) 396-6641.
Delta
Dental DDS Notification Form
This
form should be completed only by dentists with
DDS degrees
Dentist’s
Name________________________________________________________________
Address______________________________________________________________________
City____________________________
State__________ Zip__________________
License
#______________________ NPI #______________________________
Tax ID
#_______________________Corporate NPI #_____________________
Please
fax this form to (973) 285-4192
NEA Offers Discount on Electronic
Attachments
If you submit
electronic or online claims, you know they process
much faster than paper claims. But you’re
not taking full advantage of technology if you
still send supporting material such as x-rays,
perio charts and photographs by mail.
Now it’s
easier than ever to put away the stamps and start
submitting electronic attachments.
NEA is offering
a special promotion for participating dentists.
Now though March 31st, NEA’s FastAttach™ program
is just $50, a 75% discount. FastAttach lets you
submit electronic attachments to support electronic
claims. This price includes the FastAttach software,
installation, and training.
For more information,
please visit www.nea-fast.com and enter DDNJ5 in
the light blue promotion code box or call (800)
782-5150 extension 2. Be sure to mention the Delta
Dental of New Jersey special promotion.
If you’re
interested in learning more about the benefits
of sending attachments electronically, please contact
your dental network coordinator at (888) 396-6641.
Fees Updated for Delta Dental
PPO, Delta Dental Patient Direct
Fees for dentists
participating in Delta Dental PPO and Delta Dental
Patient Direct networks were updated January 1st.
New fee schedules were sent to all Delta Dental
PPO and Delta Dental Patient Direct dentists in
December.
Please contact your dental network coordinator at
(888) 396-6641 if you did not receive your fee schedule
or have questions about participating in any of our
plans.
Foundation Helps Underserved
Access Dental Care
The Delta
Dental Foundation awarded more than $560,000 to
programs that bring dental care to people in underserved
communities throughout New Jersey and Connecticut.
Foundation
grants support dental programs for schoolchildren,
senior citizens, and the developmentally disabled.
They also help fund community clinics in underserved
areas.
The Foundation
also funded several dental education grants at
colleges throughout the area. Other dental education
grants are scheduled to be approved later this
year.
2007 grant
recipients include:
East Orange
Health
& Human Services
Eva’s Village (Paterson)
Henry J. Austin Health Center (Trenton)
Hill Health Corp. (New Haven)
Hunterdon County Department of Health
Jewish Renaissance Medical Center (Newark)
Matheny Medical and Educational Center (Peapack)
Morristown Memorial Foundation
NJ Foundation of Dentistry for Persons with Disabilities
Paterson Public Schools
Virtua Health (Camden)
Zufall Health Center (Dover)
Burlington County College (dental hygiene scholarships)
Camden Country College (scholarships and dental equipment)
Somerset Medical Center (ProKIDS dental health education
program)
UMDNJ (School of Allied Health Professions scholarships
and Deckle McLean Memorial Lecture)
For more information
about our Foundation, visit our Web site at www.deltadentalnj.com.
Click “Foundation” on the left navigation
bar.
Be Sure to Disclose All Patient
Discounts on Claim Forms
Do you ever
discount your fees for patients? You should know
the rules concerning filing claims for discounted
services.
- You must
indicate any discounts you gave your patient
clearly on the face of the claim form or in the
notes field of the electronic claim.
- The discount
must be applied so that the net fee submitted
to us and the net fee charged to the patient
are both reduced.
- If you
already gave the patient a discount for a procedure,
your submitted fee for that procedure should
reflect the discounted amount.
- You may
offer patients discount coupons for services
or procedures. However, all claims submitted
must reflect the discounted fees as well.
Your submitted
fee must be the lower of the “usual” fee
or the fee actually charged to, and intended to
be collected from, your patient. The “usual” fee
is the fee you most frequently charge to and accept
from your uninsured patients as payment in full
for particular procedures (less any discount that
is regularly offered to patients, other than a
discount that reasonably reflects the time value
of money).
Regularly
offering discounts or coupons to uninsured patients
can affect your usual fee. Their use is acceptable
as long as your Delta Dental patients receive the
same discounts that your uninsured patients receive.
If you regularly offer a discount to uninsured
patients, your “usual” fee must be
reduced by that percentage.
Failure to
disclose discounts or the use of coupons is one
of the unacceptable billing practices reviewed
during the claim verification process. Failure
to disclose discounts or coupons can result in
overpayments that are recoverable. If a claim form
is intentionally submitted with undisclosed discounts
or coupon use, it can be considered a fraudulent
attempt to gain benefits.
For more information,
please refer to:
- New Jersey
State Board of Dentistry, Administrative Code
[NJAC 13:30-8.10]
- The General
Statutes of Connecticut [Volume 7, Title 20,
Chapter 379 Sec. 20-114]
- The Delta
Dental of New Jersey Participation Agreement
- The
Delta Dental of New Jersey Dentist Handbook
for Participating Dentists, Chapter 2,
Rules and Regulations and Chapter 11, Claim
Verifications
Sidebar:
How to Disclose Patient Discounts
Suppose your
usual fee for a complete maxillary denture is $1,000,
but you offer a patient a $100 discount. There
are three ways to indicate the discount on the
claim form. You must use one of the following.
Option
1: State the actual amount billed for services;
we know based on your filed usual fee that this
is a discount.
Example: Box
31: $900
Option
2: Use the “Remarks” section to identify
the dollar amount of the discount.
Example: Box
31: $1,000
Box
35: Remarks: Patient is receiving a $100 discount
Option
3: Use the “Remarks” section to identify
the percentage amount of the discount.
Example: Box
31: $1,000
Box
35: Remarks: Patient is receiving a 10% discount
Golfers, Mark Your Calendars
for June's Golf Classic
The Seventeenth
Annual Delta Dental Classic takes place June 20th at
Fiddler's Elbow Country Club in Bedminster, New
Jersey. The event raises funds for Special Olympics
New Jersey. To find out how you can participate,
contact Jennifer Appaluccio at jappaluccio@deltadentalnj.com.
Programs Help Smokers Quit Habit
More than
70% of smokers say they want to stop. The states
of New Jersey and Connecticut offer free programs
to help people quit.
New Jersey
QuitNet provides online access to peer support
and trained counselors 24 hours a day, seven days
a week. It also offers a guide to help people plan
their strategy to quit smoking. Go to www.nj.quitnet.com.
The New Jersey
QuitLine provides telephone access to trained counselors
in 26 languages. Counselors help people develop
treatment plans that meet their needs. The call
center is open Monday through Friday from 8 a.m.
to 8 p.m. (except holidays), and Saturday from
11 a.m. to 5 p.m. Call (866) NJ-STOPS (657-8677).
The Connecticut
QuitLine serves all residents who want to quit
using tobacco and offers expanded services to those
who are pregnant and uninsured. The call center
is open seven days a week from 8 a.m. to midnight,
with voice messaging available on the off hours.
Call (866) END-HABIT (363-4224).
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