Dentist blog from Delta Dental

Upcoming webinars for December: Provider Tools and Community Care Network

The holidays are here, and we’re bringing you free and informative webinars for your practice. Learn how to increase your office productivity with Provider Tools and how to expand your patient base by joining the Department of Veterans Affairs (VA) Community Care Network. Because of the holiday season, there are fewer webinars in December than usual.

Provider Tools

Provider Tools is a suite of free online tools you can use to simplify daily tasks like submitting claims, looking up patients’ histories and getting paid. These webinars will show you how to enroll in Provider Tools and how you can use it to set yourself up for practice success.

Thursday, December 2, 9:00 AM PT / Noon ET

Wednesday, December 8, 9:00 AM PT / Noon ET

Tuesday, December 14, 9 :00AM PT / Noon ET

Community Care Network

Community Care Network is the network set up by the VA for Veterans and their families to get dental care. These webinars will show you the benefits of joining and how you can sign up.

Wednesday, December 1, 11:00 AM PT / 2:00 PM ET

Wednesday, December 8, 11:00 AM PT / 2:00 PM ET

Wednesday, December 15, 11:00 AM PT / 2:00 PM ET

Assisting your HIV-positive patients

There are an estimated 1,189,700 people living in the United States with human immunodeficiency virus (HIV), according to the Centers for Disease Control and Prevention (CDC) and the mouth is one of the first areas of the body that can be affected by an HIV infection. While much progress has been made towards preventing and treating this illness, there is still much work to be done. In honor of World AIDS Day on December 1, here are some tips for assisting your HIV-positive patients.

Understand the oral manifestations of HIV

Up to 80% of people infected with HIV experience oral manifestations. HIV patients may experience the following dental health-related issues, according to the American Dental Association (ADA):

  • Dry mouth
  • Thrush
  • White lesions on the tongue
  • Red band gingivitis
  • Ulcerative periodontitis
  • Kaposi’s sarcoma
  • Oral herpes outbreaks
  • Mouth ulcers
  • Canker sores
  • Susceptibility to infections and tooth loss

When treating patients with these symptoms, it’s important to note that symptoms alone are not a diagnosis. That said, about 13% of people living with HIV in the U.S. don’t know that they have it. Urge your patients to get tested. The CDC offers a search tool for free testing throughout the country, as well as other resources.

Provide support for patients

Thanks to advances in science and technology, people living with HIV have a better outlook than ever, but proper care and maintenance is still critical. Here are a few tips for treating your patients with HIV.

  • Encourage your HIV-positive patients to keep up with their regular dental appointments, brush twice daily and floss. Most HIV-related mouth issues are treatable, yet at least 58% of people living with HIV and AIDS do not receive regular dental care.
  • If your patients are experiencing dry mouth due to medication, let them know that they should consult with their physician for other options.
  • Be sure to conduct an intraoral soft tissue, periodontal and hard tissue examination for all HIV-positive patients’ initial assessments and continue to monitor for oral health and disease progression.
  • Check your patient’s eligibility for SmileWay Wellness Benefits. If your HIV-positive patient has an eligible Delta Dental PPO™ plan and chooses to opt in, they may be eligible for added benefits, including 100% coverage for one scaling and root planing procedure per quadrant and 100% coverage for four of the following in any combination: prophylaxis, periodontal maintenance or scaling in the presence of moderate or severe gingival inflammation.

Learn more about World AIDS Day and HIV resources.

Dentist spotlight: Dr. Elijah Stephens

Dr. Elijah Stephens’s road to dentistry wasn’t always the straightest path. After studying construction management at Brigham Young University’s Marriott School of Business, he realized that dentistry would give him the opportunity to combine his passion of helping people with his love of working with his hands. It wasn’t long before joining the United States military gave him the ultimate opportunity to do just that.

Now eight years into his career, Dr. Stephens continues to serve his community as a dentist in his home state of Georgia. When he’s not spending time with his wife and three boys, Dr. Stephens still finds ways to lend a helping hand.

How did you become interested in joining the military?

A recruiter had come to our school and was talking about the benefits. My wife was not excited at all in the beginning. She thought they’d throw me out there with an M16 and say, “Good luck and go fight,” but when I talked to her about what my role would be, it changed her mindset. We played with the idea for quite some time and thought it would be a great way to be a part of something bigger. It was an amazing experience getting to be a part of the Army for six years, especially meeting the other soldiers, learning from them and being able to help a few of them out.

How did you put your dentistry knowledge to use in the military?

I was an Army dentist for six years. The first four years, I was stationed at Fort Stewart in Georgia. I got to do a humanitarian mission in Honduras. While we were there, we provided dental care to impoverished children.

I also did a small deployment in Poland, Germany and Bulgaria working as a Brigade Dental Surgeon. It was a wonderful experience and opportunity. While I was in Europe, I got to perform dental procedures on U.S. soldiers, as well as civilians and multi-national forces in all kinds of challenging areas. 

Does your military experience influence how you provide care now?

Definitely. It helped shape me at the beginning of my career. I wanted to make sure that I was doing the highest quality of work, because I knew these soldiers would be under the worst conditions imaginable and the last thing we want is someone who is trying to save our nation to be worried about a toothache. The stakes aren’t quite as high now, but the quality of my work is still important to me.

What do you love about being a dentist?

I love working with my hands. I love getting to meet people of different backgrounds and learn from them. I really like the comradery of working together for the good of those around them. Civilian practice isn’t quite as rigorous as military, so there’s more leeway with my hours and there’s a little more freedom to the structure. 

In my cosmetic work, I do veneers and crowns and help rehabilitate our patents’ smiles. We sometimes get patients who don’t like to smile because their teeth aren’t what they’d like them to be. It’s amazing the change that dentistry makes in their lives. They come in and won’t even look at you at first and then, afterwards, they look you in the eye and give you a hug and are excited to be able to smile again.

What challenges do you see in the industry?

The biggest challenge we see is misinformation on the internet. The internet is a wonderful tool, and it can be used for a lot of good, but unfortunately, some people will take anything they read online as a fact. There ends up being a lot of concerns about things that have been proven to work very well. An example would be fluoride. I have patients come in very concerned about it and that it’s going to somehow destroy their lives. I have to go through studies to show them the pros and prove that we’re using appropriate dosages to help them.

What advice would you give dentists just starting out?

Always continue learning. Any dentist that you have the opportunity to work with, whether they’re general, a surgeon, pediatric or any other specialty, take the time to learn from them. Everyone has something you can learn from, and I’ve luckily had great mentors around me who have taught me so much. Don’t be closed off and stick to only what you’ve learned in dental school. There are many schools of thought and many ways of learning.

How do you balance your work and family life?

I have three boys and they’re very active, which I love. Right now, we’ve got two boys playing football and one doing jiu-jitsu. I try to make sure I’m at as many practices as I can be at and to never miss a game. I make sure they know that they’re my highest priority.

I love dentistry, but my family and my faith come first. I want to make sure they know that. Me and my wife make sure we take time to do something together at least once a week where it’s just us. Those things give me the fuel I need to do dentistry and enjoy what I do.

How do you spend your time off?

I volunteer a bit within our community, whether it be coaching or helping out on the sidelines at football with the kids or running a group at my church where we teach 11- and 12-year-olds life skills. Just the other night we had a bonfire and discussed gun safety. This is something they’re going to see in their life, and we want them to be as safe as possible and able to learn and grow and help those around them.

At Dental Town, we also have a few days where we let patients in the community come in free of charge to get the procedures they need and get them out of pain, get them comfortable and get them on the road to a healthy smile.

Congratulations to Dr. Stephens on being our Dental Health Partner of the Month! Learn more about Dental Town.

6 things to do before the year ends

As the year comes to a close, there are some things you’ll want to take care of before a well-deserved holiday break. Make sure you’ve taken action on the following items to set yourself up for success in the new year!

1. Get ready for 2022 CDT codes

Be sure to use the new codes on claims for treatment provided after January 1, 2022. A summary of the changes introduced by CDT 2022 will be available in the Reference Library in Provider Tools in mid-December. Copies of CDT 2022 may be purchased at For more info, check out this summary of changes and claims processing policies.

2. Complete your fraud, waste and abuse training by December 31

If you’re a Medicare Advantage dentist, you’re required to complete annual General Compliance and Fraud, Waste and Abuse (FWA) certification. A big part of this is completing FWA training, but you also need to have a written ethics guide and code of business conduct for your practice. Fortunately, the steps needed to take care of this requirement are available online.

3. Take care of re-credentialing

Based on the standards of national, federal and state accrediting and regulatory agencies, we’re obligated to confirm at least once every three years that dentists in our networks are professionally qualified. If you’ve received a letter from us about re-credentialing recently, that means your re-credentialing may be due in as little as three months from the postmarked date. Make sure to complete and return your re-credentialing form and to let us know right away if the letter you received is for a dentist who’s no longer at your practice location. We’re obligated to terminate your contract if your credential expires, so don’t wait!

4. Encourage your patients to use their benefits before the end of the year

Many studies and surveys have found that most people don’t understand how insurance works. Because of this, your patients may not realize that their annual maximum has not been met and more care can be covered by their insurance. It can be helpful for your patients if you contact them while there’s still time for them to make the most of their benefits. All Delta Dental plans cover diagnostic and preventive services at low cost or no cost, so remind your patients to get their cleanings and exams before their plans reset with the new calendar year. For patients who have hit their annual maximum but still need non-urgent care, encourage them to make appointments for early in the new year.

5. Verify your taxpayer identification number (TIN)

Do we have your correct TIN in our files? Make sure that we do in order to ensure that your Delta Dental earnings are properly reported to the IRS. You can check the last four digits of your TIN on page 1 of the claim payment documents you receive from us. If those digits don’t match exactly with your TIN on file with the IRS for your name/business, notify us right away with the TIN enrollment form on our website.

6. Report any suspicions of fraud

We work diligently with all of our partners to uncover and prevent fraud. If you suspect fraud has occurred, please contact us. You can reach us through:

  • Our fraud hotline: 800-526-1852
  • Our fraud report form
  • Medicare’s fraud, waste and abuse hotline (if Medicare fraud is suspected): 800-511-0831

Have a great rest of 2021!

Your dental policy brief: Current issues and updates in the news as of November 8

From Medicare policy news to the effects of COVID-19 on the industry, FYI brings you the biggest dental policy stories.

1. Dental benefits cut from proposed 2022 Biden spending plan

Dental benefits won’t be paid for through Medicare under the Biden administration’s proposed $1.85 trillion U.S. spending plan, released on October 28. Vision benefits were also cut, while hearing benefits remain as of November 8. The three benefits, part of the original $3.5 trillion plan, were estimated to cost more than $350 billion over a decade. The cut potentially leaves 20 million people who receive Medicare but don’t receive dental benefits without dental coverage.

2. Plan extends Affordable Care Act tax credits through 2025

Biden’s spending plan extends tax credits for insurance purchased on Health Insurance Marketplace exchanges — including dental insurance — through 2025. The extension will help as many as 3 million uninsured people get coverage, according to the White House, and 4 million more may be able to get insurance through state exchanges. The proposed credits, worth approximately $130 billion, are expected to reduce annual premiums for insurance purchased through the ACA by an average of $600 per person.

3. Practices can ask for patient and employee COVID-19 vaccination status, HHS says

Asking whether patients and dental practice employees have received a COVID-19 vaccination doesn’t violate the HIPAA Privacy Rule, according to the Department of Health and Human Services (HHS). Asking employees to provide documentation of their COVID-19 vaccination is also permitted. Finally, the rule doesn’t prohibit patients or employees from disclosing this information. The rule does limit how practices can use and disclose the vaccination status information they gather, however.

4. Dentistry’s COVID recovery slipping, poll suggests

Dental practices that report their operation as “business as usual” have been declining steadily since July, poll data released October 25 indicates. 

  • Dental practices that reported being both open and having normal patient volume was down to 62% in October from 68% during July.
  • Practices reporting lower-than-average patent volumes has steadily increased, to 37% in October from 31% in July.
  • Approximately 12% of practices reported reducing staff hours in October, and 6% downsized their teams.

5. Fluoride toothpaste added to WHO’s essential drug list

The decision of the World Health Organization (WHO) to add several dental medicines, including fluoride toothpaste, to the WHO Model List of Essential Medicines is being hailed as a major achievement for global oral health. The medicines, which also included silver diamine fluoride (SDF) and glass ionomer cement, are the first dental medicines added to the list since 1973. A new section on dental preparation was also added to the list. This action comes after the WHO’s recent resolution on oral health, which calls for a global strategy action plan.

5 common reasons for QA non-compliance

California practices, do you have a quality assessment (QA) review coming up? Are you just interested in making sure your practice is up to standards? Keep your eye out for these common QA violations to stay on track for great review results.

1. Instruments and handpieces not properly cleaned, sterilized or stored.

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Tip: If you have two or more sterilizers in the office, indicate on bag labels which sterilizer was used in case you receive a positive spore test result.

2. Medical emergency drug kit not on-site.

Violated guideline: All dental offices must be equipped with an emergency drug kit. Dentists must know when and how to use each drug.

Tip: Include a log in the kit that lists all emergency drugs on hand and their expiration dates. Do not include any drugs that have expired. A basic emergency kit should include:

  • injectable epinephrine
  • injectable diphenhydramine
  • nitroglycerin tablets
  • bronchodilator (albuterol)
  • chewable aspirin
  • a sugar source

3. Biological (spore) testing of sterilizers not done weekly.

Violated guideline: Each sterilizer in the office must be spore tested at least weekly.

Tip: Document in a log the spore testing process for all sterilizers, including the pass/fail results of each test. Maintain the results for at least 12 months and be sure they are on site and available for inspection during your QA review.

4. Handpieces and waterlines not flushed appropriately.

Violated guideline: Operatory unit waterlines must be flushed for two minutes in the morning before use and for 20 seconds between patients, according to the California Code of Regulations, section 1005 of Division 10 Title 16.

Tip: All staff should be able to demonstrate this task before your QA examiner.

5. Cold-sterilization log not kept.

Violated guideline: Disinfection solutions must be changed regularly, according to the manufacturer’s recommendations. When establishing change schedules also consider usage.

Tip: Keep a log of every sterilization solution change. In your log, include the brand name, date changed, name of person changing the solution and the calendar date of expiration. Make sure the log is available during your QA review.

Getting acquainted with the aspects of a QA review is an important way to improve your practice’s policies and procedures, while also preparing for future on-site assessments.

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