FYI

Dentist blog from Delta Dental

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Get to know Medicare Advantage

Every day for the next decade, about 10,000 Americans will turn 65. It’s estimated that by 2030, approximately 18% of the nation’s population will be 65 or older.

This means that every single day, more and more people become eligible for insurance coverage through Medicare and can purchase supplemental Medicare Advantage dental plans through approved vendors like Delta Dental. If you want your practice to serve this growing population of patients, joining Delta Dental’s Medicare Advantage network is the perfect place to start.

Why should you join Delta Dental’s Medicare Advantage network?

Joining Delta Dental’s Medicare Advantage network can provide a substantial boost to both attracting and keeping patients:

  • Enrollment in Medicare Advantage has more than doubled over the past decade, and enrollment continues to increase by as much as 9% a year.
  • Most Medicare Advantage groups offer a closed-panel benefit package. This means patients covered under these plans must see a dentist contracted in the Medicare Advantage network.
  • When you join our network, you’ll appear in our online Medicare Advantage directory, which can help new patients find you.
  • Being part of Delta Dental’s Medicare Advantage network can help you keep your existing patients as they reach age 65 and become eligible for Medicare.

What if you’ve already opted out of participation in Medicare?

You can still join our Medicare Advantage network.

Rules that prohibit payment to providers who have opted out of participation in Medicare don’t apply to supplemental benefits like dental, according to the Centers for Medicare & Medicaid Services (CMS). The policy became effective on January 1, 2022. Even if you’ve opted out of Medicare through CMS, you can still join the Delta Dental Medicare network and provide services to our Medicare Advantage members.

What about non-covered services?

If you’re contracted with Medicare Advantage networks, you can charge Medicare Advantage patients for any non-covered service. Members must simply give informed consent so they are aware of any out-of-pocket costs.

How do you join Delta Dental’s Medicare Advantage networks?

If you’re interested in joining, all you need to do is send us an email.

Email ProviderConcierge@delta.org for the DHMO Medicare Advantage network and medadv@delta.org for the PPO Medicare Advantage network. We’ll email you an application.

Access the DeltaCare USA emergency preauthorization form online

When your DeltaCare® USA patients need referral for emergency treatment, you can easily download the emergency preauthorization form online.

What is the emergency preauthorization form?

The emergency preauthorization form allows you as a primary care DeltaCare USA dentist to refer your patients to a specialist for emergency treatment.

The form captures the issues you’ve diagnosed as well as your recommendations for treatment. It also informs specialists that such treatments may not normally be covered under the patient’s DeltaCare USA plan.

How to find the emergency preauthorization form

To download the form from our website, visit the Administrative and claim forms page. The form is listed under Dentist Administrative Forms and Resources.

Coming soon: Continuing education courses for Delta Dental dentists

Staying up to date on new trends and techniques in dentistry is essential for dental professionals. That’s why we’re partnering with dental schools across the country to offer continuing education courses to Delta Dental dentists at a discount.

You’ll earn continuing education credits that can help you meet licensure requirements, improve your clinical skills and provide optimum care for your patients.

What courses will be available?

Here’s a quick look at the courses that will be available this fall. Our course list is continuously growing, with new courses coming soon.

DateSchoolCourse titleStateCredits
10/7/2022University of Pittsburgh School of Dental MedicineDigital Dentistry: The Engine that Supercharges Practice GrowthPA6
10/14/2022University of Alabama at Birmingham School of DentistryIntegrative Dental Medicine: The Next Great FrontierAL6
10/15/2022University of California San Francisco School of DentistryPeriodontics and Oral MedicineCA6
10/28/2022The Dental College of Georgia at Augusta UniversityGeneral Dentistry & Problem SolvingGA6
10/29/2022Nova Southeastern University College of Dental MedicineUsing Risk Assessment for Treatment Planning in DentistryFL6
Nov. 2022Columbia University, College of Dental MedicineManagement of Special Needs Patients and Pediatric Dental TraumaNY6

While most courses are planned for in-person sessions, this is subject to change depending on the public health situation, and virtual offerings may also be available.

Who’s eligible to sign up?

These courses are available to all dental professionals, but as a Delta Dental network dentist, you can enjoy a special discount when you enroll.

How can I sign up?

Registration will be available through the hosting school. Enrollment isn’t yet open, but details will be coming soon.

To stay in the loop, subscribe to FYI for monthly updates in your inbox, attend an upcoming webinar for more info and bookmark the training and events page, where flyers with more details will be posted over the next few weeks. We’ll also send out targeted emails by state to let you know about the upcoming courses in your area.

Watch out for allergies in the dental office

In 2019, an 11-year-old girl died after using a toothpaste prescribed by her dentist. The toothpaste contained milk proteins and the girl, who was acutely allergic to dairy, had a severe anaphylactic reaction. Tragically, despite being treated immediately with an injection of epinephrine and receiving CPR, she couldn’t be revived.

This is a chilling reminder that being aware of both your patients’ allergies and what might trigger them is crucial when providing care. While you’re probably aware of your patients’ allergies to medications and anesthesia, being aware of uncommon allergies to common dental products is equally important.

Here are a few tips to help ensure you’re prepared.

Make sure your patients disclose all their allergies — do some digging

When providing you with their medical history, patients may disclose only the allergies they assume are relevant. Be sure to explain to patients that you need to be aware of all their allergies, even those that are seemingly unrelated to their treatment, such as allergies to foods or dyes. It’s also a good idea to ask how severe those allergies are and what their typical reaction is.

Know what’s in the products you use

Be diligent about knowing what the products you use contain and which ingredients may be allergy risks, and have alternatives available for patients with sensitivities. Here are some possible allergens to be aware of.

Latex

Latex is frequently found in dental products other than gloves, including a few that might not be immediately obvious, such as:

  • Dental dams
  • Interdental picks
  • Mouth props
  • Prophy cups
  • The nose bridge of patient safety glasses

Gluten

While gluten is commonly associated with breads and grains, it can pop up in a surprising number of dental products, including:

  • Fluoride products
  • Oral prostheses and appliances made with methyl methacrylate or MMA, such as dentures, retainers and temporary crowns
  • Prophy pastes
  • Sample products for patients
  • Therapeutic agents
  • Whitening systems

Dairy

As noted earlier, certain dental products contain dairy, most commonly toothpastes and sugar-free gums that contain an ingredient called Recaldent, which is made from a milk protein.

Food additives

Additives used to enhance the taste or appearance of certain oral hygiene products may cause allergic reactions. Triclosan, sodium lauryl sulphate and sodium lauryl sarcosinate in toothpaste, and cinnamic aldehyde, proflavine, benzydamine, chlorhexidine and alcohol in mouthwashes have been shown to cause allergic reactions in people sensitive to these substances.

Metals

Metals found in fillings, dentures, implants and orthodontic appliances have caused reactions in patients sensitive to them. Possible culprits are nickel alloys, mercury and titanium. For fillings, consider composite resin, glass ionomer or porcelain materials as options. 


Tragic outcomes are rare, but the risk is always present. But with due diligence and a few questions, you can minimize the risk of allergic reactions and ensure that you provide your patients with the safest care possible.

Too few kids are getting fluoride treatments: What you can do

Dental fluoride treatments are among the most effective and efficient techniques for hindering tooth decay in children. But despite their proven effectiveness, and despite the fact that such treatments are often covered by insurance, too few children are getting them.

Very few privately insured young children receive recommended dental fluoride treatments at health wellness visits, according to a study published in the Journal of the American Medical Association (JAMA) Network Open. The study’s analysis of more than 328,000 well-child visits for privately insured 2- to 5-year-olds found that fluoride treatment was done in fewer than 5% of visits between 2016 and 2018.

Parental refusal and clinical intervention strategies

One common reason that children aren’t getting fluoride treatments is parental refusal. In a survey, nearly 80% of dentists said they believed fluoride refusal was a problem. In one study, refusal of fluoride was found to be correlated with refusal of vaccines, and as many as 51.5% of parents refused topical fluoride treatments.

“Tooth decay is the number one disease of early childhood, and fluoride plays a critical role in strengthening the enamel and preventing cavities,” said Dr. Jessica Buehler, Director of Dental Affairs at Delta Dental. “Unfortunately, in today’s world of information overload and patients getting their news through social media, there are many families that oppose or do not understand the value and importance of fluoride.” 

Reasons for parental refusal

Parental attitudes and beliefs about health are important determinants of fluoride refusal. Most common is the belief that fluoride is unsafe. Such concerns are often spread and amplified through social networks, the media and the internet. Other factors may include religious beliefs, a desire for autonomy and concerns about the true intent of fluoride treatments.

Clinical interventions

The following clinical strategies can help you improve communication with parents about topical fluoride treatments:

  • Assess parents’ knowledge, beliefs and attitudes early. Screen for possible fluoride hesitancy at the start of preventive visits by asking open-ended, non-judgmental questions, such as “Do you have any questions for me about fluoride?” This can help you assess beliefs and start a conversation.
  • Ensure your team is prepared. Make sure your staff of dental assistants and hygienists understands how fluoride works and why it’s important, as they will likely be the ones applying fluoride treatments. Acknowledge that parental refusal can be a problem and assure your staff that you are there to support them. “Auxiliary staff should not engage in an argument when a parent refuses fluoride,” suggested Dr. Buehler. “They should inform the dentist so that she or he can answer any questions the family may have.”
  • Obtain information about why parents are refusing fluoride. Avoid a pro-fluoride “sales pitch.” Instead, ask questions about what’s motivating a parent’s decision to opt out. Listening is key and can help build trust. Reassure the parent that you respect their health care decisions. Some parents may reconsider their decision after several discussions over time. Document conversations with parents so that future discussions can be framed appropriately.
  • Incorporate specific caries risk factors into discussions. Provide parents with an explanation of why fluoride is important based on the unique risk factors associated with each child. For instance, white spot lesions on the child’s teeth should be pointed out to the parent, with a description on how fluoride helps to prevent white spots from turning into cavities that require fillings.
  • Discuss alternative fluoride sources and behavioral strategies. Parents who refuse fluoride during dental and medical visits may be open to use of at-home fluoride products. Discuss alternative sources of fluoride that could be used at home, like fluoridated toothpastes and fluoride mouthwashes. Remind parents about the benefits and safety of fluoride in water. For parents who refuse all fluoride-containing products and water, emphasize that reducing dietary sugars and acids becomes even more critical in managing caries risk.

Fluoride treatments, your pediatric patients and you

Fluoride varnish is recommended by the U.S. Preventive Task Force and the American Academy of Pediatrics for all infants and children starting at tooth eruption through age five years. All children in this age category should receive fluoride varnish application at least once every six months, according to the recommendation. Most private insurers cover the procedure, and coverage with no cost-share for families is mandatory under the Affordable Care Act.

Most Delta Dental PPO™ and DeltaCare® USA plans cover fluoride treatments for children up to age 12, and many cover such treatments up to age 18, and for adults, as well. The specific codes for fluoride treatments are:

  • D1206 Topical application of fluoride varnish
  • D1208 Topical application of fluoride excluding varnish

Preventive dental care is important at any age, and we encourage you to give regular fluoride treatments to your pediatric patients. Developing a clinical workflow that includes fluoride application can greatly improve the oral health of children within your practice.

Let direct deposit work for you

Getting paid is a breeze when you take advantage of direct deposit from Delta Dental. You’ll get fast payments, safe document storage and more.

How does direct deposit work?

Getting paid electronically is simple. Once you enroll, Delta Dental electronically deposits claim payments into your bank account. Whenever a new payment has been deposited, you’ll receive an email notice from Delta Dental. We’ll also electronically send your claim payment details to your account.

Why use direct deposit?

Direct deposit is:

  • Easy. Simply enroll online to get started.
  • Fast. Payments are deposited more quickly into your bank account than with mailed checks, making funds available sooner.
  • Eco-friendly. Direct deposits cut down on the need for mailed checks and other paperwork, as well as reducing the need for bank visits.
  • Convenient. Your electronic remittance advice and pre-treatment estimates are viewable online, and they’re printable whenever you choose, reducing clutter.
  • Safe. With direct deposit, information about your claims and payments is safely stored and viewable for you online. Avoid the headache and hassle of lost, delayed or stolen paper checks.

How do I enroll?

Log in to Provider Tools and select EFT and ERA. (Electronic funds transfer (EFT) transmits funds for claims payments directly into your bank account. Electronic remittance advice (ERA) is an electronic version of the explanation of benefits (EOB) for claims payments.)

To fill out the online form for direct deposit, you will need to provide:

  • Your contact information, including your name, address, email address, contact name and phone number.
  • Your Taxpayer Identification Number (TIN). Note: If you have more than one practice location under a TIN, you’ll need to enroll separately for each location.
  • Your National Provider Identifier (NPI). Under federal HIPAA provisions, direct deposit is a transaction that requires an NPI.
  • Your bank/financial institution information, including your routing number and the account type and number (make sure your bank is a member of the Automated Clearinghouse Association – ACH).
  • Bank information confirmation, such as a copy of a voided check or a bank letter that verifies the bank routing number and account number.

Allow 15 business days for your request to be processed. You can make changes to your account information at any time, or even cancel your EFT enrollment, by using the EFT and ERA tool in Provider Tools.

Can I enroll in direct deposit with all Delta Dental companies at once?

Yes. As you fill out the direct deposit enrollment form, you’ll see a section titled Delta Dental Member Company Data Sharing Authorization for EFT. To enroll for direct deposit with all Delta Dental companies at once, simply select Opt in to National Sharing.

How often will I receive electronic payments?

Payment frequency depends on your claim activity. Delta Dental issues payments at least once a week. For the fastest claims processing, submit free real-time claims using the Submit Claim or My Patients tools. Claims are often processed within moments.

How will I receive claim payment statements (explanation of benefits/EOBs)?

Delta Dental sends details for each payment to My Documents, which is easily accessible by logging in to your account and selecting My Claim Documents. You can view all the payment details right there in your account, or you can choose to download and save them elsewhere and/or print them.

Where can I get more information?

Visit Provider Tools for additional information, videos and live webinar schedules that can help simplify reimbursements and many other aspects of your practice.

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