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Articles
Delta Dental to Launch Improved Online
Eligibility Enrollment
Special Note for Tape Submitters
Flagship-DeltaCare Satisfaction Survey Results
Please Help Us Fight Fraud
Cost Containment Report Released
Benefits Connection
Delta Dental Classic Raises $50,000 for Special
Olympics
An Easy Way for Employees to Maximize Their
Dental Benefits
Delta Dental to Launch Improved
Online Eligibility Enrollment
Delta Dental Plan of New Jersey is about to roll
out two new online services later this summer. One
will greatly simplify the task of eligibility enrollment.
The other will allow subscribers to receive instant,
detailed information about their Delta Dental benefits
via the convenience of the Internet. Access to information
is password-protected and secure.
Online Eligibility Enrollment
Hundreds of benefits managers count on Delta Dental's
online Eligibility Enrollment feature to enroll
and terminate subscribers. Now, this feature is
undergoing a major enhancement. When the new and
improved Eligibility Enrollment debuts, it will
include additional options, such as change, transfer
and reinstatement. Benefits managers will be able
to view the subscriber's profile and view their
submission log. "Delta Dental developed this
service to make your job easier, save you time
and better help you serve the employees who work
for your company," says Jean McGowan, Director,
Premium Billing.
Making eligibility changes online offers several
advantages to benefits managers.
- It reduces errors and confusion. Currently, eligibility
changes are sent to Delta Dental in a variety of
ways, including faxes, e-mails, phone calls and
letters. Handwritten changes are often difficult
to read, and frequently require follow-up phone
calls to clarify or confirm information. Online
eligibility enrollment eliminates this step. The
online system even prompts users if they forget
to include any necessary information.
- It's fast and easy to use. There is no paper
to handle. Everything is managed right from the
benefits manager's desktop.
- It records eligibility changes faster than before.
Benefits changes take effect within 24 hours -
often sooner.
- It simplifies record-keeping. Benefits managers
can easily view their submissions and profiles,
and print out reports.
Special Note for Tape Submitters
Benefits managers who submit eligibility changes
by tape should note that the tape always overrides
what is in Delta Dental's system. If you make changes
online, you also must make those changes in your
system. Online eligibility enrollment is still an
advantage because it offers you the ability to quickly
make changes - and have them take effect - between
tapes.
Flagship-DeltaCare Satisfaction
Survey Results
DeltaCare participants indicated overwhelming satisfaction
with their program, according to a survey conducted
late last year by Brownstone Information Resources
of Morristown, New Jersey, for Flagship-DeltaCare.
DeltaCare is a dental HMO-type program that provides
a comprehensive level of dental benefits at an affordable
price. DeltaCare is often offered in conjunction
with other Delta Dental programs, allowing employees
to choose the best combination of cost and benefits
for themselves and their families. DeltaCare is administered
by Flagship Health Systems, Inc., a subsidiary of
Delta Dental Plan of New Jersey, Inc.
The survey was sent by mail to 1,000 randomly selected
plan participants who received dental services from
their DeltaCare participating dentist in the last
12 months. From this pool, 385 members responded.
Among the findings:
- Members rate their experience with Flagship-DeltaCare
highly. Factors contributing to overall satisfaction
include their comfort with the dentist, ease of
traveling to the dental office, experience with
customer service, possible out-of-pocket cost for
coverage and overall oral health. Eighty-five percent
expressed overall satisfaction with DeltaCare.
- Members give the program high scores for value.
When asked to measure the benefits received from
the plan for the money spent, members rated Flagship
at a high level of 87%. Ninety-four percent are
satisfied with the plan's routine coverage, such
as cleanings and x-rays. For non-routine services,
such as gum work, root canals, caps, crowns, dentures
and fillings, 66% expressed satisfaction.
- Members say they are satisfied with the quality
of care. Eighty-five percent of those surveyed
said they are satisfied overall with their primary
care dentist. Factors contributing to their overall
impression about their dentist include quality
of work, personal interaction (people skills) and
accessibility (convenience). Eight-eight percent
reported being satisfied with the quality of treatment
provided by their primary care dentist. Even higher
grades were given for the dentist's ability to
treat needs (89%) and provide relief of symptoms
(89%). Members also felt that dentists explained
treatment options satisfactorily (89%), gave advice
on how to avoid dental problems (89%) and offered
instructions for follow-up care (90%). Similarly,
members were very pleased with the treatment they
received from office staff (91%). In addition,
high levels of satisfaction were given for the
overall quality of care received from specialists
(88%).
- Convenience factor also earns high scores. More
than eight out of 10 members rated their ability
to access primary dental care highly. Nearly nine
of 10 find their dentist's office conveniently
located. About seven out of 10 members rated the
ease of scheduling appointments satisfactorily,
although some participants comments on longer-than-expected
waits. Also, many members wish the network of Flagship-DeltaCare
dentists was larger.
- Members rate Flagship-DeltaCare customer service
highly. Members gave this area an overall satisfaction
rating of 88%. Customer service agents rated highly
in both courtesy (95%) and how accurately they
answered members' questions (91%). "As evidenced
by the high level of satisfaction in nearly all
categories, Flagship-DeltaCare is meeting the needs
of its members," said the survey report.
"Overall satisfaction with the quality of
dental care, and levels of satisfaction with overall
plan coverage and costs are all rated highly."
Please Help Us Fight Fraud
Delta Dental Plan of New Jersey would like all of
its subscribers to help Delta Dental in its fight
against insurance fraud. Insurance fraud costs insurance
companies, and ultimately its groups and subscribers,
billions of dollars each year. If this problem were
to be curbed, it would save everyone money. We are
asking that each of you review your notice of payment
carefully when you receive it and that you immediately
notify us about any questionable charges, dates or
other apparent errors by calling us at 800-452-9310.
We believe that the great majority of dental care
providers are honest and are willing to correct errors
that they may make in their billing. However, there
is a minority of dentists who engage in overbilling
and it is important that any questionable charge,
no matter how small, should be brought to our attention
for review. Listed below are a few categories of
concern. Each of them has a brief explanation as
to the nature of the problem and why it should concern
you.
No Charge or Over-Charge
This occurs when (1) your dentist does not charge
you for a service, but bills your insurance company
or (2) your dentist bills you a lesser fee than
is charged out to your insurance company for the
service(s). If the dentist is not charging you
for a service or charging you a lesser fee than
is being reflected to your insurance company, then
your insurance company could be paying out more
money than it actually should.
Service Not Performed
This occurs when a dentist submits a claim to your
insurance company for services that were not performed
or completed. As per your group's contract, services
are not permitted to be billed until they are complete.
If you notice an incorrect date of service on your
notice of payment, you should notify us to that
fact. An incorrect date could lead to future claims
being denied due to time and frequency limitations.
Coordination of Benefits Not Reported
All Delta Dental and American Dental Association
claim forms have a section where the dentist must
indicate if there is another insurance carrier,
whether dental or medical. This is important, not
only to Delta Dental, but also to the other insurance
company, as payment is based on whether other coverage
exists. If insurance companies are not aware that
other coverage exists, the company may in fact
make an incorrect payment and that may use up your
available benefits.
All of the above concerns ultimately result in a
higher cost to you and your company. You should report
any billing discrepancies to us at 800-452-9310.
If you suspect fraud, you may contact us at 888-696-3262.
Cost Containment Report Released
Delta Dental saved clients and subscribers close
to $150 million last year, thanks to our cost-containment
measures and by diligently managing administrative
costs. To view our complete "Cost Containment
Report for 2000,"
visit our website at www.deltadentalnj.com and click
on
"Manager's Office."
Benefits Connection
The new online Benefits Connection makes it possible
for subscribers - and their dentists - to obtain
instant, detailed information about their benefits.
Subscribers can easily determine what services are
covered by their specific program, the percentages
that Delta Dental will cover, and whether there are
deductibles, maximums or waiting periods. With the
online Benefits Connection, subscribers no longer
need to pore through benefit booklets or notification
of payment statements, or call Customer Service to
find the information they need. It's all at their
fingertips, 24 hours a day, seven days a week, 365
days a year. Subscribers can very quickly find their
answer through Benefits Connection. What's more,
they can also have their dentists (even non-participating
dentists) access this information, so subscribers
and dentists together can make informed decisions
about their treatment options.
Watch for more information about online Eligibility
Enrollment and Benefits Connection shortly.
Delta Dental Classic Raises
$50,000 for Special Olympics
The eleventh annual Delta Dental Classic, which
drew 126 golfers to the Cherry Valley Country Club
on June 5, raised $50,000 for Special Olympics programs.
Since the Delta Dental Classic began in 1991, the
event has raised more than $300,000 for Special Olympics
New Jersey.
Contest winners include:
1st place Low Gross (Ladies): Dr. Leslie Skurla
1st place Low Gross (Men): Jeff Simpson
1st place Gross Team: Bob Allen, Jeff Simpson, Don
Fisher, John Bartaccio
Special thanks to all of our participants and sponsors.
The date for next year's Delta Dental Classic is
June 4, 2002.
An Easy Way for Employees
to Maximize Their Dental Benefits
Subscribers get the most value from their Delta
Dental benefits when they visit participating network
dentists. Since three out of four dental offices
in the United States participate with the Delta Dental
system, chances are good that your employees' dentists
are part of our Plan.
But in cases where the dentists don't participate,
employees have several options. They can switch to
a participating provider. Or, depending on their
plan, they can continue seeing their non-participating
dentist and pay higher out-of-pocket expenses.
Or, they can help assist us in recruiting their
dentist to become a participating provider. It's
easy. All they need to do is complete the information
below. Delta Dental will contact the dentist directly.
Employees have nothing to lose - and benefits to
gain - by taking a few minutes to help us serve them
better!
If Your Dentist Doesn't Yet Participate with Delta
Dental, Try This!
Yes! I would like you to contact my dentist about
becoming a participating dentist with Delta Dental!
My name
Social Security number
Group number
You may/may not (please choose one) use my name when
contacting the dentist.
Dentist's name
Dentist's address
Dentist's phone number
Plan type:
[ ] DeltaPremier [ ] Delta's Advantage
Program
[ ] DeltaPreferred Option [ ] DeltaCare
Please fax this information to 973-285-4140 or mail
it to: Delta Dental Plan of New Jersey, Inc.; Attn:
Professional Relations Department; P.O. Box 222;
Parsippany, New Jersey 07054.
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