Articles
Dentist Credentialing Program Nearly
Complete
Incorrect Addresses Delay Claim Payments
A Patient Says Thanks
What Our Not-for-Profit Status Means
Technology Update
Dental Benefits Called Major Factor
in Americans' Oral Health
But Those Without Coverage Suffer
Online FAQs Improved
Golfers Raise $45,000 for Special Olympics
Mark that Date!
Dentist Credentialing
Program Nearly Complete
Every participating dentist in Connecticut and most
participating dentists in New Jersey have now completed
Delta Dental's credentialing process.
Delta Dental began its credentialing program in
response to requests from employers groups. "Many
of our employer groups include credentialing as a
standard part of their proposal request and decision-making," says
Bruce Silverman, Senior Vice President. "They
want to know what criteria we use to choose participating
dentists, and how we ensure that dentists meet those
criteria. Also, corporations are looking for more
accountability from us regarding their dental costs."
Although verifying credentials cannot totally
ensure quality dental care, the process is
consistent with patient protection laws supported
by many dental organizations. Medical carriers
have been required to check the credentials
of their participating doctors for many years.
The credentialing questionnaire asks dentists
for general office information and specific
information about their dental licenses, specialty
certifications, insurance coverage and infection
control policies. Each dentist in a practice
must submit a separate questionnaire.
Connecticut finished credentialing its 2,000
dentists in September 2000. New Jersey began
its credentialing process in February 2000.
In New Jersey, as of November 2000, 70% of
DeltaPremier's dentists, 60% of Delta's Advantage
Program's dentists and 65% of DeltaPreferred
Option's dentists have been credentialed. All
New Jersey DeltaCare dentists have been credentialed.
Incorrect
Addresses Delay Claim Payments
Do your employees know if their dentist has their
correct address? Incorrect patient addresses are
a major reason behind claim-processing delays.
Please remind your employees that they can help
Delta Dental serve them better by verifying their
address at each appointment. It's a quick, easy way
to make sure payments arrive in a timely manner.
A Patient
Says Thanks
"I would like to say thank you," writes
a subscriber with Delta Dental. "I had dental
work done while on vacation. The dentist submitted
the claim and called me one week later. He wanted
to make sure I was feeling better and to tell me
that the payment had been mailed to his office. He
could not believe how quickly the claim had been
processed. Within two weeks, the claim had been processed
and paid. I appreciate your company's quick processing,
before a financial strain is placed on the family.
So thank you, and keep up the excellent work."
What
Our Not-for-Profit Status Means
For our subscribers, Delta Dental is an influential
partner in maintaining oral health. But we're not
an insurance company. Delta Dental Plan of New Jersey
is a not-for-profit dental service corporation, which
means we contract with organizations to administer
their dental-care plans on a prepaid basis.
As a not-for-profit dental service corporation,
Delta Dental operates a bit differently than an insurance
company. First and foremost, we are able to focus
on our primary mission - improving the oral health
of those we serve.
Secondly, Delta Dental does not have stockholders,
nor is it a publicly traded company. This means that
the dollars collected for the administration of dental
benefits plans go toward your group's benefit program
- not for stock dividends. Our not-for-profit status
also contributes to keeping premiums in check and
our administration costs low, which further adds
to the value of a Delta Dental program. In fact,
the vast majority of each premium dollar pays directly
for dental care. The balance pays for the careful
review of claims, dental audits and customer service
for you and your group members - hallmarks of the
Delta Dental program.
The balance also pays for research, product development
and oral health campaigns in the communities we serve.
As a not-for-profit entity, we are committed to giving
back to our community through our philanthropic arm,
the Delta Dental Foundation of New Jersey. Among
the many programs supported include PANDA (Prevent
Abuse and Neglect through Dental Awareness) program,
which educates dentists and others on the warning
signs of child abuse; Captain Supertooth, the superhero
of dental hygiene, who visits New Jersey schools
to spread the word to students about the importance
of good oral hygiene; the Bloomfield Health Careers
Foundation, which trains dental assistants and dental
hygienists; the Paterson Dental Clinic, to provide
supplies used to treat children of the Paterson School
District; and the Dover Free Clinic and Kimball Dental
Clinic to provide dental care to those in need.
Technology
Update
Delta Dental Plan of New Jersey is in the process
of rolling out its new CTI Customer Service enhancement.
What is CTI? CTI allows information that the caller
has input from their touch-tone phone to "pop" information
onto the Customer Service Representative's computer
screen as the call arrives at their desk. This will
save you time and eliminates having to repeat information
you have given to the Voice Response System.
As an example, assume you want a breakdown on benefits.
Once you have entered the member's identification
number on the telephone keypad, if the call is transferred
to a representative, that person will have the member's
record appear in front of them as you are connected.
To get the most out of this technology, we need
your assistance!
- You should use the Voice Response System as often
as possible to obtain information on eligibility,
benefits, claims status, remaining maximum and
deductibles and to order forms.
- If you choose to speak with a representative,
always first enter the member's identification
number. This will reduce the time the representative
will need to obtain information to assist you.
Delta Dental continues to look for opportunities
to improve our service to you.
Obtaining Provider Listings
The fastest, easiest ways to obtain listings of
providers near you are:
- Visit our website at www.deltadentalnj.com and
click on "Find a Dentist."
- Call 800-DELTA OK (335-8265).
Dental
Benefits Called Major Factor in Americans'
Oral Health
Americans are hearing less of the dental drill as
a result of spending more time visiting their dentists
for routine exams, according to Delta Dental Plans
Association, the national network of independently
operated not-for-profit dental service corporations
of which Delta Dental Plan of New Jersey, Inc., is
a member.
Since the early 1970s, dental care has witnessed
a dramatic shift from treatment to prevention. The
results of a Delta Dental Plan of Michigan study
evaluating the claims data of insured dental patients
confirm that this shift has led to exciting improvements
in oral health. Research indicates improvements in
the increased use of dental benefits, quality dental
service, education and widespread use of fluoride
are factors contributing to the trend.
In 1970, only 7% of all Americans had private dental
coverage. Today, nearly half of the U.S. population
is covered by employer-sponsored dental plans. Increased
access to dental benefits encourages patients to
seek regular checkups. The Michigan study revealed
that scheduled oral exams have increased from one
annual visit to 1.5 since 1980.
While routine dental checkups have increased, treatments
for common dental ailments have decreased. From 1978
to 1990, tooth extractions declined 41 percent, and
fillings were reduced by 52 percent. In 1960, the
average American over age 65 had just seven of his
or her original teeth. With today's level of dental
care, baby boomers can expect to have at least 24
teeth left at that same age.
Delta Dental Plan of Michigan examined 15 years
of claims data from approximately 750,000 individuals
with Delta Dental benefits. The following statistics
were drawn from the survey:
- Scheduled oral exams have increased from one
annual visit to 1.5 since 1980.
- Fillings have decreased 45 percent in adults
aged 64 and younger since 1970.
- The need for full dentures for beneficiaries
under the age of 35 literally ended by 1990, and
is rapidly declining among all older age groups.
- Simple extractions for patients 45-54 have decreased
by nearly 45 percent.
"Results from this study clearly indicate that
people attach a higher priority to maintaining their
teeth and a healthy mouth," said Roger C. Smith,
DDS, chairperson of the Delta Dental Plans Association's
Dental Policy committee.
"It's clear that regular, preventive care translates
to longer-lasting teeth and better overall oral health."
But
Those Without Coverage Suffer
Nearly half of all American lack dental benefits,
one of several factors that prompted the non-profit
advocacy group Oral Health America to give the nation
a C-minus on its first Oral Health Report Card. "We
have found that there are serious problems in terms
of access to oral health care," says Surgeon
General David Satcher. (Satcher was not involved
in the preparation of this report card, but was instrumental
in developing the Surgeon General's report on "Oral
Health in America.") Roughly 108 million Americans
are without dental coverage, many of them children
and the elderly. Only one in five children on Medicaid
sees a dentist in any given year.
Fluoridation was another factor affecting the nation's
oral-health grade. There are 100 million people who
live in areas without access to fluoridated water.
New Jersey was one of 11 states that received an
F in this area, for failing to bring fluoridation
to even 10% of residents. Connecticut received a
B for fluoridation.
Online
FAQs Improved
Do you have a question about your dental benefits?
Finding the answer is easier than ever when you visit
Delta Dental's recently updated "FAQs" section
on our website. The new FAQs (for "Frequently
Asked Questions") section features three easy
ways to obtain the answers you need.
- You can browse the list of the most frequently
asked questions and their answers. This list includes
everything from how to find a participating dentist
to assigning benefits, checking deductibles and
maximums, and much more.
- You can search the solution database using simple
keywords or phrases. For example, if you want to
know about documentation for full-time students,
just type the word student and click on "Search
Right Now." A drop-down list appears of all
FAQs that include the word student.
- If you don't find the information you need using
the previous methods, you may click on the "Ask
Us Right Now" icon to e-mail your question
directly to our Customer Service Department. A
Customer Service Agent will quickly respond to
your request. (You may also reach Customer Service
by e-mailing service@deltadentalnj.com.) The FAQ
database will be continuously updated to include
frequently asked questions submitted to Customer
Service via "Ask Us Right Now."
To access FAQs, go to www.deltadentalnj.com and
click on
"FAQs" from the menu.
Golfers
Raise $45,000 for Special Olympics
When rain threatened to dampen the Tenth Annual
Delta Dental Classic in June, organizers felt that
canceling the event was not an option. Last year's
golf outing, which supports Special Olympics New
Jersey, had also been rained out. "We couldn't
disappoint golfers and Special Olympics supporters
two years in a row," said Diane Belle, Assistant
Vice President, Corporate Communications.
Rescheduled for August 21, the event at Cherry Valley
Country Club drew 130 golfers and raised more than
$45,000 for Special Olympics programs. Since it began
in 1991, the Delta Dental Classic has raised $270,000
for Special Olympics New Jersey.
Contest winners include:
1st place Low Gross (Ladies) - Leslie Skurla
1st place Low Gross (Men) - Tom Miller
1st place Gross Team - Kevin Croly, James DeMarco,
Tom Miller, Pat Scheffer
Special thanks to all of our participants and sponsors!
Mark
that Date!
The Eleventh Annual Delta Dental Classic will take
place on June 5, 2001, at Cherry Valley Country Club.
The golf classic benefits Special Olympics New Jersey.
More details will follow shortly.
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