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Articles
NEA Discounts New Service for
Participating Dentists
Filing Electronic EOB Claims
Call Center Schedule Changes for Summer
2006 Annual Report Published
South Jersey's New Dental Network
Coordinator Benefits from Stints on 'Both Sides of the
Desk'
Seventeenth Annual Delta Dental Classic
This Month
More than 120 Turn Out for CT Delta
Dental Days
You're NPI Ready, but Is Your Practice
Management System?
Massachusetts Members Switch to Non SSN
IDs
Please Fax Us Your NPI Number
If You Prescribe, Think About Getting an NPI
NEA Discounts New Service for
Participating Dentists
Ever wish there was an easy way to figure out what attachments insurance companies require? NEA’s new
FastLook service enables dental offices to visit one site to view payors’ attachment requirements. Simply search by insurance company name and procedure code to view attachment requirements. This eliminates the need to send unnecessary attachments.
FastLook hosts up-to-date information and is available online 24 hours a day 7 days a week, all for one low annual fee of $40.
Once you know which attachment is required to process your claim, you can send it electronically with NEA’s
FastAttach service. FastAttach lets you submit electronic attachments to support electronic claims.
To help you get started, NEA has a special promotion for participating Delta Dental dentists. Register for
FastLook before July 31st and receive a free FastAttach registration ($200 value, which includes software, installation and training).
FastAttach has a low monthly fee of $20 for unlimited transmissions. As long as you remain a
FastAttach customer, you will continue to receive the
FastLook service at no additional cost.
To take advantage of this special offer please visit www.nea-fast.com, enter DDNJ in the blue promotion code box and click Find My Promotion. Or, call (800) 782-5150 ext. 2. Be sure to mention the DDNJ special promotion.
As always, you can also visit our Web site to view Delta Dental of New Jersey specific attachment requirements. Go to www.deltadentalnj.com. Click “Dentists” and “Required Documentation Charts” under “Professional Services.”
Filing Electronic EOB Claims
With more and more offices converting to online and electronic claims submission, we continuously search for ways to improve our processes. Our latest improvement is on coordination of benefit (COB) claims when the other insurance has paid a $0 benefit.
Previously, a copy of the other insurance EOB was required for documentation of the reason for the $0 payment. We now accept that information without requiring submission of the EOB as long as a clear explanation of why there was a $0 payment is provided in the Remarks or Notes section. This change applies to both New Jersey and Connecticut.
The Remarks or Notes section should also be used to indicate the Primary plan’s Maximum Allowable Charge for the claim. That amount is required for accurate processing under the State of New Jersey COB rules.
Remember, you should use the Remarks or Notes section to communicate valuable information to Delta Dental. Any claim received with comments gets routed to a Delta Dental associate for review. Unnecessary comments such as “You must process this claim in xx days” will actually just delay processing.
Call Center Schedule Changes for
Summer
Our Customer Service call center hours will change on June 18 through the first week of August.
The temporary schedule is:
- Monday, Tuesday and Thursday from 8 a.m. to 6:30 p.m.
- Wednesday from 12:30 p.m. to 6:30 p.m.
- Friday from 8 a.m. to 10:45 a.m.
We reduced our hours at times when call volume is traditionally low. This allows us to undergo a major training initiative.
Our normal Customer Service schedule resumes the week of August 6.
Need patient information at other times? As always, Benefits Connection and our Voice Response System are available all day, every day. They provide automated answers to most patient eligibility, benefits, and claims information. To access Benefits Connection, go to www.deltadentalnj.com. Click “Dentists” and log on to Benefits Connection. To access the Voice Response System, please call Customer Service at (800) 452-9310 and follow the automated prompts.
2006 Annual Report Published
Delta Dental’s 2006 Annual Report, called “The caring behind the smiles,” highlights our business and philanthropic achievements. In 2006 those included:
- Retaining 95% of our customers.
- Processing nearly 2.9 million claims.
- Earning “excellent” or “above average” satisfaction scores from the vast majority of benefits managers, members, and brokers surveyed.
- Distributing more than $500,000 in grants to dental clinics and educational clinics in underserved areas of New Jersey and Connecticut.
- Providing more than $200,000 to support dental hygiene and dental assisting programs at New Jersey high schools and colleges.
To order your free copy of Delta Dental’s 2006 Annual Report, visit our Web site at www.deltadentalnj.com. Click “About Us” on the left navigation bar. Then go to “Annual Report.”
South Jersey's New Dental
Network Coordinator Benefits from Stints on 'Both
Sides of the Desk'
Susan Chase started her career in dental offices. Now she’s back in them as our new Dental Network Coordinator for southern New Jersey.
She’s proud to serve as the “face” of Delta Dental and help dental offices see the value of participating in our networks.
“I love representing Delta Dental,” she says. “I believe in our product, and know first-hand that it makes life easier for patients and dental offices.”
Chase started working in dental offices right after high school and continued while her children were growing up. (They are now ages 26, 28 and 30.) She worked for general practice dentists, orthodontists, pedodontists and oral surgeons. She earned both the Registered Dental Assistant (RDA) and Certified Dental Assistant (CDA) designations.
“When I worked in the dental office, I loved it when patients had Delta Dental,” Chase says. “It made my job so much simpler. Now that I’m on the other side of the desk, I get to tell people in dental offices about everything we offer that can simplify their jobs.” One way is with online claims. Chase can show dental offices how to start submitting online and electronic claims, which are easier to submit and process faster than paper claims.
Chase also helps dental offices get more value from participation. “We have several dental networks, and I can show you how they can help your practice grow.” She can also explain how your practice can save money on products and services through our In-Net discount program. And, Chase will answer questions about everything from NPI numbers to how to use Benefits Connection to check your patients’ benefits online.
She joined Delta Dental in Parsippany seven years ago, and worked in both Customer Service and Professional Review before being named a Dental Network Coordinator.
Chase has moved to southern New Jersey to be closer to the dental offices she serves. “This is a great move for my husband and me,” she says. “We have family in the area. Plus, I’m very happy to represent Delta Dental in southern New Jersey, and am looking forward to building a strong relationship between participating dentists and Delta Dental. I’ve already met so many wonderful people and look forward to meeting many more.”
Seventeenth Annual Delta Dental
Classic This Month
It’s almost tee time at the Delta Dental Classic. The annual golf event benefits Special Olympics New Jersey.
The Delta Dental Classic takes place on June 20 at Fiddler's Elbow Country Club in Bedminster, New
Jersey - one of the finest golf courses in New Jersey
- and helps a truly worthy cause. It’s raised more than $553,000 for Special Olympics New Jersey.
For information, contact Jennifer Appaluccio at jappaluccio@deltadentalnj.com. Or visit our Web site at www.deltadentalnj.com and click “download the invitation” in the “What’s New” section.
Hope to see you there!
More than 120 Turn Out for CT
Delta Dental Days
The latest Delta Dental Day program drew more than 120 dentists and their staff members to the Aqua Turf Country Club in Plantsville, Connecticut.
The half-day program covered:
- News about the National Provider Identifier (NPI) number
- How to submit electronic claims
- The appeals process
- Preventing insurance fraud
- Using online Benefits Connection to check patient benefits and file claims
Participants gave it top marks for content and presentation.
“This was very informative,” said one attendee. “It was time well spent.”
“Awesome info on NPI, attaching files and the overall discussion of dental insurance today,” said another.
“Thank you for all the helpful information,” said a third.
The next Delta Dental Day will be this September in New Jersey. For registration information, contact your dental network coordinator at (888) 396-6641. Participants are eligible to receive 4 CEU credits.
You're NPI Ready, but Is Your
Practice Management System?
For those of you who have applied for NPIs, you already know how quick and easy it is to complete the process. While you can feel good about being among the ranks of the enumerated, you might not be done with NPI preparations just yet. Have you checked to be sure your practice management system is NPI ready?
After the 20 minutes it takes to apply for an NPI, it is estimated that up to 120 more days are needed for you to prepare to use and share your NPI(s). Much of the work involves getting billing systems in order, which should include a call to your practice management vendor. Ask if your system can support the transmission of NPI compliant claims (known as HIPAA 837 dental claims). If not, system upgrades might be in order.
If you submit claims to a clearinghouse, make arrangements with them to be sure that the claims they submit on your behalf are NPI compliant. All should be prepared to handle an NPI in claims, and some may even have systems in place to make the conversion from legacy identifiers to your new NPI for you. Delays in applying for and using your NPI can put your cash flow at risk. To find out more information about NPI compliance, visit the official government NPI Web site at: http://www.cms.hhs.gov/NationalProvIdentStand/. You may also obtain information at
www.deltadentalnj.com/npi/npi.shtml
Massachusetts Members Switch to
Non SSN IDs
If any of your patients are covered by Delta Dental of Massachusetts, they now have new ID numbers. Delta Dental of Massachusetts converted to non-Social Security subscriber ID numbers over Memorial Day weekend.
New ID cards with the new numbers are being sent to those subscribers in June.
If you have questions, please visit www.deltadentalma.com or call Delta Dental of Massachusetts at (800) 872-0500.
Please Fax Us Your NPI Number
Effective May 23, 2007, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of the National Provider Identifier (NPI), a standard unique identifier for healthcare providers and organizations that are defined as covered entities under HIPAA. Providers who transmit health information in electronic form via standard HIPAA electronic transactions are considered covered entities.
In order to avoid delays in claims processing, please send us your NPI number.
Dentist Name: __________________________________________________
TIN #: _________________________________________________________
License #: _____________________________________________________
Office Address: ________________________________________________________________
________________________________________________________________
Type 1 NPI # (Provider) _________________________________
** More than one dentist? Please download a form at www.deltadentalnj.com; click “Dentists,” then “NPI Information” and “NPI Fax Form.”
Type 2 NPI # (Corporation) ______________________________
Signed_____________________________________________ Date__________
PLEASE FORWARD THIS INFORMATION TO:
Delta Dental of New Jersey
Professional Relations
PO Box 222
1639 Route 10
Parsippany, NJ 07054
Or fax this form to (973) 285-4192
If You Prescribe, Think About
Getting an NPI
If you write prescriptions for your dental patients, you should consider applying for an NPI. Regardless of whether you’re considered a “covered entity” under the NPI regulation or not, using an NPI to identify yourself on prescriptions will make it easier for pharmacies to fill patients’ prescriptions and for those claims to be processed quickly and accurately.
All dentists and health professionals are eligible to apply for an NPI and are encouraged to get one. Some dentists are considered “covered entities” under the NPI standard because they are involved in electronic transactions such as submitting and checking claims online. These health professionals were required by federal law to use NPIs on all transactions beginning May 23, 2007.
If you’re not considered a “covered entity,” there are a number of reasons to consider applying for and using an NPI in place of other identifiers.
Because of the requirements of a number of individual payers, pharmacies will have a more difficult time with prescription claims that do not include NPIs. According to the National Council for Prescription Drug Programs, about 80% of the 4 billion real-time pharmacy transactions require prescribers to be identified on claims. The NPI can be used as this identifier, replacing payer specific prescriber identifiers.
In addition to the benefits of using an NPI on pharmacy claims, there are other reasons that it makes good business sense. With one simple identification number, there’s no need to maintain and match different identifiers to specific payers for transactions. The number stays with you, even if you move. It contributes to a more efficient coordination of benefits.
Finally, if you decide to begin using electronic transactions, it’s an easy transition. The application process is quick, simple and free. To find out more information about NPI compliance and to apply for your NPI, visit the official government Web site at:
http://www.cms.hhs.gov/NationalProvIdentStand/. You may also obtain information at
www.deltadentalnj.com/npi/npi.shtml.
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