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Dentist blog from Delta Dental

Tag: benefits (Page 1 of 4)

Access thousands of patients with NY Select

Gain access to over 200,000 NY members with 100% benefits for covered services when you enroll as an NY Select dentist! When you participate in the NY Select network (formerly known as NYPPO), you can help provide your fellow New Yorkers with dependable, quality dental care.

This network is specific to New York state and is the only in-network option for members of two large union health plan/funds:

  • DC37 is the largest public employee union in New York City, with 150,000 members serviced by the District Council 37 Health & Security Plan. DC37 members help make New York run by working in over 1,000 titles — everything from accountants to zookeepers.
  • 32BJ is a branch of Service Employees International Union (SEIU) that is headquartered in New York City. The Building Service 32BJ Health Fund services over 75,000 of New York’s property service workers.

DC 37 and 32BJ’s NY members are benefited 100% for covered services with NY Select participating dentists.

Delta Dental ensures that members are able to find your office by providing special dentist directories especially for DC37 and 32BJ patients.

Everything you’ll need for administration, including how to register for direct deposit, view treatment history and obtain claim status, is available in your Provider Tools account. 

Simply log in or register to access these handy tools:

  • Reference Library: Find your Dentist Handbook and other information.
  • My Patients: Obtain eligibility and benefits for current and new patients.
  • Submit Claims: Transmit free, real-time claims and attachments.
  • My Account: Update your directory profile to ensure patients can find you.

Interested in participating in the NY Select network? Please contact Delta Dental Network Development Representative John Wilson by email at jwilson@delta.org or phone at 628-260-4764.

Not sure if you’re already participating in the NY Select network? Or currently participating and have questions? Please contact our Provider Concierge by email at providerconcierge@delta.org or by phone at 800-592-0156.

Please note: The NY Select dentist network is separate from Delta Dental PPO™ and Delta Dental Premier®. Please review your NY Select contract and fee schedule for additional information.

SmileWay Wellness Benefits help patients stay healthy

More patients are becoming aware of the way that health issues can manifest in the mouth and oral health issues can exacerbate other medical conditions. With serious issues like heart disease being responsible for so many deaths in the U.S., your patients may be interested in learning how good dental health can improve their overall health. For patients who have medical conditions that affect their oral health, SmileWay® Wellness Benefits may be available to help meet their needs.

Who’s eligible for SmileWay Wellness Benefits?

Not all patients are eligible for SmileWay Wellness benefits. To claim these benefits, patients must:

  • Have a Delta Dental PPO™ plan
  • Belong to a group that offers SmileWay Wellness Benefits
  • Have chosen to opt in to the program

Members who have been diagnosed with any of the following are eligible for expanded coverage:

  • Diabetes
  • Heart disease
  • HIV/AIDS
  • Rheumatoid arthritis
  • Stroke

What are the benefits?

Members whose plans offer SmileWay Wellness Benefits are eligible for these added benefits each calendar or contract year:

  • 100% coverage for one scaling and root planning procedure per quadrant (D4341 or D4342)
  • and 100% coverage for four of the following in any combination:
    • Prophylaxis (D1110 or D1120)
    • Periodontal maintenance procedure (D4910)
    • Scaling in the presence of moderate or severe gingival inflammation (D4346)

If you have patients with medical issues that necessitate extra dental care, find out if they’re eligible for SmileWay Wellness Benefits. These benefits can help keep them both smiling and healthy!

Dental implants are coming to DeltaCare USA

A new kind of large group plan is coming to DeltaCare® USA plans in 2021. Effective January 1, 2021, DeltaCare USA i-series plans will be available with comprehensive coverage for dental implants. Once i-series plan rollouts are complete (there will be nine in total), they will be available in all 50 states and Washington, D.C.

These plans are designed to address the growing demand by DeltaCare USA members for dental implants. These plans will include coverage for all major codes related to the placement and removal of dental implants and abutments. Coverage of implants means you have another tool in your toolbox when it comes to recommending the best treatments for your patients.

For more information on the i-series plans, please consult your DeltaCare USA benefits book.

DeltaCare USA individual plan launched in Nevada

Did you know that dental benefits have a positive effect on patient health? For example, insured patients are 50% more likely to visit the dentist each year than the uninsured.1

Increasing access to dental care is at the core of what we do. That’s why we offer several Delta Dental plan choices for individuals — a DeltaCare® USA plan, now available in eight states and the District of Columbia,2 and two Delta Dental PPO plans.3

These plans help your patients replace plans lost to retirement or job changes. And, it’s easy to enroll online for a basic plan, or one with more inclusive benefits.

Download and save the individual and family plans overview to share with your patients.

Join us! If you’re not in the PPO and/or DeltaCare USA networks, consider joining. You’ll get the maximum in-network benefit payment directly from us, gain more insured patients through our online dentist directory and retain patients who may choose to purchase a closed network plan. Visit our website for more information.


1According to the Delta Dental Oral Health and Well-Being Survey [2014] by Delta Dental Plans Association.

2The closed network, prepaid DeltaCare USA plan is available in CA, DC, FL, MD, NV, NY, PA, TX and UT.

3The open network, fee-for-service PPO plans are available in AL, CA, DC, DE, FL, GA, LA, MD, MS, MT, NV, NY, PA, TX, UT and WV.

Informed consent is key to patient satisfaction

Ensuring that patients understand their financial responsibility for treatment, including treatment that is not covered under their dental benefits plan, can help safeguard their overall satisfaction with your practice.

A good way to accomplish “informed consent” (as required under your Delta Dental participation agreement) is with a thorough discussion about treatment, alternatives and costs, along with a form or other documentation that includes the same information and the patient’s written acknowledgement of the discussion. Points to discuss and document include:

  • The agreed-upon course of treatment and specific non-covered services
  • The patient’s acknowledgement of non-covered services and personal responsibility for the cost
  • Risks and advantages of proposed and alternative treatment
  • Costs for necessary subsequent treatment, such as a crown after endodontic therapy

In addition, we strongly recommend that you submit a pre-treatment estimate before providing any non-covered services (or any expensive and/or extensive services). Though not usually required, a pre-treatment estimate has several advantages, including further helping patients understand their benefits and financial obligations.

Much of this information is covered in your Dentist Handbook, which is updated periodically. Be sure to review it regularly by logging in and using the Reference Library.

 

Intel patients have risk-based benefit

Intel Corporation adopted a risk-based approach to dental care on January 1, 2018. Its Delta Dental PPO™ plan (group #05178) includes the following per calendar year for your Intel patients:

  • One exam for adults at low risk for oral health problems
  • Two exams for children to age 14 and high-risk adults, including those who have had restorative, endodontic or periodontal treatment within the last three years
  • Either two cleanings or up to four cleanings for patients with certain periodontal or chronic conditions

Log in and use Provider Tools to review detailed benefits information, treatment history and claim status.

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