Articles
HIPAA: How Will the Mandatory Reforms Affect You?
Mark that Date!
PANDA Helps Dentists ID Child Abuse
April is Child Abuse Prevention Month: What You Can Do
Got a Minute? That's All the Time Our Website Survey Takes
Delta Dental Sends Captain Supertooth On Statewide Tour to Teach Students About Oral Health and Prevention
Association Names Tracy Customer Service Representative of the Year
Lori Acker Named ICSA President
Please Share Subscriber News with Employees!

HIPAA: How Will the Mandatory Reforms Affect You?

HIPAA stands for the Health Insurance Portability and Accountability Act of 1996. It's a federal law intended to provide better access to health insurance, lower administrative costs, and secure and keep private protected health information.

Administrative Simplification
A major provision of HIPAA is called Administrative Simplification. It's the part of the law released in 1996 that addresses the maintenance and transmission of electronic health information. Administrative Simplification mandates the standardization of electronic transmissions for many administrative and financial transactions in an effort to reduce overall costs and administrative burdens in the healthcare system.

The United States Department of Health and Human Services (DHHS) is required to develop standards and requirements for all health information while ensuring that the data can be securely and confidentially shared. To do this, the department is in the process of composing a set of rules that define and support the national standards in areas such as the privacy of individually identifiable health information, electronic transactions and code sets, security and electronic signatures, and provider and employer identifiers.

What is the Goal of Administrative Simplification?
The goal is to implement national standards that will encourage electronic commerce in the healthcare industry and ultimately simplify the processes involved. Currently, there is no common standard for the transfer of healthcare information. For example, at this time, about 400 formats exist for healthcare claims. Conformity to national standards will make electronic data interchange (EDI) a viable and preferable alternative to paper processing.

Who Is Affected?
All health plans (including ERISA plans), healthcare clearinghouses and healthcare providers transmitting data in electronic form must comply or be subject to substantial fines. For example, any claim submitted electronically must comply with HIPAA requirements. This means dental offices submitting electronically have two options: ensure the format the use is HIPAA compliant, or rely on an electronic clearinghouse to convert the claims data into a HIPAA format.

Delta Dental is continuing to monitor HIPAA legislation and, as each rule is finalized, is positioned to bring our systems into compliance. Additionally, we'll continue to provide you with updates about this important legislation.

Is There a Deadline for Adopting the HIPAA Standards?
Regulations are still evolving and the rules are in various stages of development. Once a rule has been finalized, organizations have between 24 and 36 months to comply. For example, the deadline for compliance with the Electronic Transaction Standards is October 2002.

For more information about this federal mandate, you can visit http://aspe.hhs.gov/admnsimp/.

Mark that Date!

It's almost tee-time! The Eleventh Annual Delta Dental Golf Classic takes place on June 5, 2001, at Cherry Valley Country Club in Skillman, New Jersey. The golf classic benefits Special Olympics new Jersey, a non-profit organization that provides athletic training and competition for children and adults with mental retardation. For registration information, please call 973-285-4059.

PANDA Helps Dentists ID Child Abuse

Tens of thousands of children in New Jersey and Connecticut are victims of child abuse each year. Delta Dental's PANDA (Prevent Abuse and Neglect through Dental Awareness) program is working hard to save them from further injury. PANDA, funded by Delta Dental's philanthropic arm, the Delta Dental Plan of New Jersey Foundation, educates dental office personnel, teachers and school nurses about how to recognize and report suspected cases of child abuse and neglect.

Dentists have a unique opportunity to detect child abuse injuries. Nationally, about 65% of child abuse injuries involve the head, neck or mouth areas. However, a disproportionately lower percentage of the 50,000 cases of child abuse reported each year in New Jersey come from dentists. The reason for this low reporting rate by dentists may be related to lack of training and concerns about the ramifications of becoming legally involved in such cases. Studies indicate that dentists educated in this area are nearly five times as likely to report suspected abuse.

Many people, including dentists, are reluctant to report suspected child abuse because they are uncertain whether an injury resulted from abuse or something else. PANDA shows dentists how to identify the difference between accidental injuries and those inflicted by a guardian or caretaker.

Thousands of dentists have attended PANDA programs throughout New Jersey and the country. Programs are offered several times a month, not only to dentists, but also to school nurses, teachers and other health-care providers.

April is Child Abuse Prevention Month: What You Can Do

• Wear a blue ribbon. Prevent Child Abuse-New Jersey in April runs its Blue Ribbon campaign, which Delta Dental supports. Through volunteers, community agencies and businesses, the organization plans to distribute more than 375,000 ribbons this year, which people wear throughout the month to raise awareness of the problem. Each ribbon comes with information on how to prevent child abuse. For information, call (800) CHILDREN or visit its website at www.preventchildabusenj.org.
  
• Report suspected cases of abuse. In New Jersey, contact your local DYFS District Office between 9 a.m. and 5 p.m. There is at least one District Office in every county. After hours, the Office of Child Abuse Control operates a toll-free hotline round the clock, at (800) 792-8610. In Connecticut, call the CARELINE at (800) 842-2288. Anyone who reports abuse or neglect, or testifies in a child abuse hearing resulting from such a report, is immune from any criminal or civil liability as a result.

Got a Minute? That's All the Time Our Website Survey Takes

Delta Dental's website is at www.deltadentalnj.com.

Delta Dental Sends Captain Supertooth On Statewide Tour to Teach Students About Oral Health and Prevention

In commemoration of National Children's Dental Health Month in February, the popular Captain Supertooth, the Delta Dental Plan of New Jersey Foundation, Inc. superhero of dental hygiene, visited school children throughout New Jersey to promote the importance of early preventive dental care and teach them proper oral care.

The Captain Supertooth program is part of Delta Dental's ongoing initiative to spread the word that oral health is vital for good overall health.

In the Surgeon General's report on Oral Health, poor children were identified as having twice as much tooth decay as other children. One of the barriers to good oral health in certain "underserved" populations has been access to information on oral care. Delta Dental addresses this need through Captain Supertooth, a hero that appeals to children from all socioeconomic backgrounds and makes learning about good dental habits interesting and fun.

Captain Supertooth visits schools armed with a larger-than-life-sized toothbrush and other fun props. During the program, the Captain shares helpful "teeth" tips, such as using toothpaste in a pea-sized amount on a soft-bristled toothbrush, remembering "don't rush when you brush" by brushing for at least one minute, eating a balanced diet, and visiting the dentist for regular check-ups.

"Decay can occur as soon as a child's first tooth appears," reports Dr. Scott Navarro, Dental Director, Delta Dental Plan of New Jersey. "Therefore, it's imperative that children learn how to brush and floss properly at a very early age."

Some parents may question the importance of caring for baby teeth, since they will eventually fall out. According to Dr. Navarro, severe decay can be painful and can sometimes cause teeth to fall out. When a baby tooth is lost to decay, it is no longer holding the space in the jaw for the permanent tooth. This can affect chewing, speaking and appearance.

The emotional trauma caused by tooth loss can cause psychological effects that undermine a child's ability to socialize normally and perform well in school. Dental health also impacts absenteeism. Each year, 51 million school hours are lost due to dental disease. This year Captain Supertooth visited a total of 30 schools throughout the state of New Jersey. For more information, call Delta Dental at 973-285-4059.

Association Names Tracy Customer Service Representative of the Year

Lisa Tracy, a Customer Service Agent with Delta Dental Plan of New Jersey, was named the customer service representative of the year by the Garden State Chapter of the International Customer Service Association. Chosen by a group of her peers, Tracy won the award because of her ability to extend herself to resolve problems on a daily basis.

"We feel that Lisa exemplifies what Delta Dental represents - a caring company with a sincere desire to provide superior service to all our customers," explains Carol Legreid, Tracy's team leader. "Lisa receives numerous compliments regarding her professional and helpful manner from our subscribers and dental providers."

The award was given by the Garden State Customer Service Association, which is the New Jersey chapter of the 2,000-member national organization. The Garden State chapter has approximately 100 members that 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 that truly goes above and beyond his/her job description. The award is given the first week of October to coincide with National Customer Service Week.

Tracy has been a Customer Service Agent with Delta Dental Plan of New Jersey for two years and is now a Senior Customer Service Agent. She resides in Madison, New Jersey.

Lori Acker Named ICSA President

Lori Acker, Delta Dental's Assistant Vice President, Customer Service, was elected president of the Garden State Chapter of the International Customer Service Association. The Garden State Chapter is comprised of approximately 100 customer service professionals interested in enhancing their professional development through attendance at seminars, chapter meetings and networking. The chapter offers several formal and informal gatherings each year where members have an opportunity to learn about such topics as technology, hiring, and customer retention. "My goals during my presidency are to 'grow' the membership and offer productive, high quality meetings for our members and guests," says Acker.

Please Share Subscriber News with Employees!

Also, be sure to tell your employees about Delta Dental's website, at www.deltadentalnj.com. They can use the site to find a participating dentist in their area, gain answers to Frequently Asked Questions about their dental benefits, download claim forms and even access the latest issue of Subscriber News.