SearchSite MapContact UsContact Us
Error processing SSI file
Current Location: Home > Dentists > News >
Newsletters - December 2004
 

Articles
Benefits Managers Give Delta Dental High Marks
COB Claims Can Now Be Submitted Online
Key CDT-2005 Code Changes and DeltaUSA Processing Policy Revisions
Delta Dental Receives 'AA-' Rating From Standard & Poor's for Fifth Consecutive Year
Benefits Connection Spotlight: Keith Bohleke, Quality Dental Care
Tech-Niques: Understanding Your Internet Connectivity Options
Delta Dental Donates to Three Clinics
Submission of Claim Forms Checklist

ADA Helps Kids Answer Question, "What Do You Want To Be When You Grow Up?"

Wanted: Used Dental Equipment for Clinics

Captain Supertooth Begins Tour in January, February


Benefits Managers Give Delta Dental High Marks

We are pleased to report that Delta Dental continues to receive high overall ratings from benefits managers. In the 2004 Benefits Managers' Satisfaction Survey, nearly 9 in 10 benefits managers reported being "extremely satisfied" or "very satisfied" with Delta Dental. Ninety-five percent would recommend Delta Dental to other administrators.

Brownstone Information Resources, Inc., an independent market research firm in Morristown, New Jersey, conducted telephone interviews with 250 benefits managers selected at random in August. 

How Benefits Managers Rated Our Performance in 2004

Percentage who are "Extremely" or "Very Satisfied" with Delta Dental - 86%

Percentage who would recommend Delta Dental to other administrators - 95%

Percentage who said Delta Dental performs "extremely" or "very well" at processing claims accurately - 82%

Percentage who said Delta Dental performs "extremely" or "very well" at processing claims quickly - 81%

Percentage who said Delta Dental performs "extremely" or "very well" at allowing employees/members to choose their own dentist - 80%

Percentage who said Delta Dental performs "extremely" or "very well" at having Customer Service agents who are knowledgeable - 76%

Percentage who said Delta Dental performs "extremely" or "very well" at having Customer Service agents who are courteous/pleasant/empathetic - 79%

Benefits managers also believe their employees are satisfied with Delta Dental. Three-quarters said their employees are "extremely" or "very happy" overall.

The mission of Delta Dental Plan of New Jersey is "to promote oral health to the greatest number of people by providing accessible dental benefit programs of the highest quality, service, and value." The annual survey helps ensure that we continue to serve our customers to the high standards set by our mission.


COB Claims Can Now Be Submitted Online

Delta Dental expanded our online claim submission feature. Dental offices may now submit coordination of benefits (COB) claims online. 

The following types of claims and pre-treatment estimates can be submitted online:

  • Claims with dated services no Coordination of Benefits (COB)
  • COB with carrier other than Delta Dental Plan of New Jersey (DDPNJ)
  • COB with two or more Delta Dental Plan of New Jersey coverages
  • COB with capitation
  • Pre-Treatment Estimate (PTE) for non-dated services
  • Payment of a PTE with no COB (must have a PTE voucher number)

When submitting COB claims with two or more Delta Dental coverages, simply select the type of claim that applies. If the primary claim can process all the way through, our system will generate the secondary claim at the time of your submission.

If the primary claim pends, we will generate the secondary claim when we process the primary claim. You do not need to indicate COB in the "Comments" section. We will know because you told us up front when you submitted the claim type. Comments cause all claims to pend and should only be included when the additional information is necessary for us to process the claim (e.g., indicating handicap status). 

Online claim submission offers several advantages for dental offices. It is done in real time, thereby eliminating the delays the clearinghouse step usually entails. Claims go directly from your office to ours.

There are no per-claim submission fees, whether you submit one claim or hundreds. Payment is about 50% faster than with paper claims.

To start submitting claims and PTEs online, go to www.deltadentalnj.com, click on "Dentists," and log onto Benefits Connection. First-time users must click on "Register Now."


Key CDT-2005 Code Changes and DeltaUSA Processing Policy Revisions

This abbreviated list includes Delta Dental Plan of New Jersey/DeltaUSA Processing Policies as revised to incorporate CDT-2005 as well as other policy changes. Effective January 1, 2005, Delta Dental Plan of New Jersey participating dentists agree to abide by these policies. To obtain a CDT-2005 manual, you must contact the American Dental Association catalog sales at (800) 947-4746 or www.adacatalog.org.

CDT-2005 Procedure Code Nomenclature and Current or Proposed DeltaUSA Processing Policy

D0277 Vertical Bitewings
(1) Vertical bitewings are considered bitewings for benefit purposes and go against the time limit frequencies for bitewing films in the contract. If the fee for the vertical bitewings is equal to or exceeds the fee for full mouth series, it would be considered a full mouth series for payment benefit purposes and time limitations. The fee in excess of the fee for full mouth series of radiography is DISALLOWED.*

(2) If the fee for the bitewing and occlusal radiographs is equal to or exceeds the fee for a full mouth series, it would be considered a full mouth series for payment benefit purposes and time limitations. The fee in excess of the fee for the full mouth series is DISALLOWED.

(3) The fee for any type of bitewings submitted with a full mouth series are considered part of the full mouth series for payment and benefit purposes. Any fee in excess of a full mouth series is DISALLOWED.

(4) In the absence of contract language for bitewing frequency limitation, bitewings of any type are DISALLOWED within 12 months of a full mouth series.


D2910
- Recement inlay, onlay, or partial coverage restorations 
D2915 - Recement cast or prefabricated post and core
D2920 - Recement crown
D6930 - Recement fixed partial denture
(1) Delta Dental Plans consider the cementation date to be that date upon which the completed cast post, prefabricated post and core, inlay, onlay, or fixed partial denture is first delivered to the mouth. The type of cement used is not a determining factor (whether permanent or temporary).

(2) Fees for recementation of cast or prefabricated post and cores, inlays, onlays, crowns, and fixed partial dentures are DISALLOWED if done within six (6) months of the initial seating date by the same dentist or dental office.

(3) Benefits will not be considered for payment of a recementation until at least six (6) months have elapsed since initial placement. At that time one recementation may be paid. Subsequent requests for recementation by the same provider are DENIED and the approved amount is collectable from the patient. Benefits may be paid when billed by a provider other than the one who seated the bridge or performed the previous recementation.

D2934 - Prefabricated esthetic coated stainless steel crown--primary tooth
(1) A prefabricated esthetic coated stainless steel crown is a benefit only on anterior primary teeth. If submitted for a posterior primary tooth or for a permanent tooth, an alternate benefit allowance for D2930 or D2931 is made. The difference between the allowance for the D2930 or D2931 and the approved amount for the D2934 is DENIED and collectable from the patient.

(2) A fee for replacement of a stainless steel crown on a primary or permanent tooth by the same dentist/dental office within 24 months is included in the initial crown placement and is DISALLOWED. The fee for replacement within 24 months of initial placement by a different dentist/dental office is DENIED and the approved amount is collectable from the patient.

(3) Benefits may be allowed with the same processing policies and edits as a D2933 if performed on permanent teeth and subject to individual consideration.


D2975 - Coping
(1) Copings are considered an integral part of the final restoration. Additional fees are DISALLOWED.


D4265 - Biologic materials to aid in soft and osseous tissue regeneration
(1) D4265 (Emdogain only) may be eligible for stand-alone benefits when reported with periodontal flap surgery and only when billed for natural teeth and performed for periodontal purposes. Benefits for these procedures when billed in conjunction with implants, ridge augmentation, extraction sites, periradicular surgery, etc., are DENIED as a specialized or elective technique.

(2) When submitted with a D4263, D4264, D4266, D4267, D4270, D4273, D4275 or D4276 in the same surgical site, the fee for the D4265 is DENIED. When a D4265 is submitted with an extraction or periradicular surgery, the D4265 is DENIED and the approved amount is collectable from the patient. If a D4265 is reported with D7950 or D7955, refer to medical.

D4266 - Guided tissue regeneration - resorbable barrier, per site
D4267 - Guided tissue regeneration - nonresorbable barrier, per site (includes membrane removal)
Benefits for guided tissue regeneration are DENIED in conjunction with soft tissue grafts in the same surgical area.

D6190 - Radiographic/surgical implant index, by report
Benefits are DENIED unless implant services are covered, per contract. Under contracts with implant coverage, diagnostic and treatment facilitating aids are considered a part of definitive treatment and separate benefits for an index to the same dentist/dental office are DISALLOWED.


D6205 - Pontic -indirect resin based composite 
Benefits will be considered for a conventional fixed prosthesis. The difference between the allowance for the conventional prosthesis, and the approved amount for the D6205 is DENIED and collectable from the patient.

D6710- Crown - indirect resin based composite 
Benefits will be considered for a conventional fixed prosthesis. The difference between the allowance for the conventional prosthesis and the approved amount for the D6710 is DENIED and collectable from the patient.

D7311 - Alveoloplasty in conjunction with extractions- one to three teeth or tooth spaces, per quadrant
The fee for D7311 performed by the same dentist/dental office in the same surgical area on the same date of service as surgical extractions (D7210-D7230) is DISALLOWED.

Count bounded tooth spaces for D7311 partial quadrant code.

A bounded tooth space counts as one space irrespective of the number of teeth that would normally exist in the space.

D7321 - Alveoloplasty not in conjunction with extractions - one to three teeth or tooth spaces per quadrant
Count bounded tooth spaces for D7321 partial quadrant code.

A bounded tooth space counts as one space irrespective of the number of teeth that would normally exist in the space.

D7511 - Incision and drainage of abscess intraoral soft tissue- complicated (includes drainage of multiple fascial spaces)
General Policy - This procedure is by report and is subject to coverage under medical. 

The fee for surgical incision is DISALLOWED when done on the same date (in the same operative area) and by the same dentist/dental office as endodontics, extractions, palliative treatment or other definitive service.

D7953 - Bone replacement graft for ridge preservation-per site
General Policy - This procedure is by report and is subject to coverage under medical. 

Benefits for osseous autografts and/or osseous allografts are available only when billed for natural teeth for periodontal purposes using periodontal procedure codes (D4263-D4264). Benefits for these procedures when billed in conjunction with implants, ridge augmentation, extraction sites, periradicular surgery, etc., are DENIED as a specialized or elective technique. If the contract covers dental implants, this procedure may be a benefit at the time of extraction.


D7963 - Frenuloplasty
A separate fee for frenuloplasty is DISALLOWED when billed in conjunction with any other surgical procedure(s) in the same surgical site.


D9450 -- Case Presentation, Detailed and Extensive Treatment Planning
(1) The fee for extensive treatment planning is DENIED and the approved amount is collectable from the patient.

(2) The fees for routine treatment planning and case presentation are considered inclusive in an evaluation and are DISALLOWED.

(3) The fee for extensive treatment planning may be benefited for complex treatment planning cases involving multiple treatment disciplines and multiple providers of care.

(4) When covered, the D9450 is subject to the same frequency limitations and processing policies as a comprehensive evaluation (D0150).

D9942 - Repair and/or reline of an occlusal guard 
(1) An occlusal guard and related repair and/or reline are not a covered benefit unless it is contract specific. The fee is DENIED.

(2) If covered contractually, the fee for the occlusal guard includes any adjustment or repair required with six (6) months of delivery. Fees for the adjustment or repair of the occlusal guard are DISALLOWED if performed by the same dentist/dental office within six (6) months of initial placement.

(3) General Policy- If covered contractually, the fee for repair of an occlusal guard cannot exceed one-half of the fees for a new appliance, and any excess fee is DISALLOWED.

Local Variation: Delta Dental Plan of New Jersey may utilize the DeltaUSA National Account Processing Policies as previously set forth or the following variations on said processing policies where Delta Dental Plan of New Jersey is the Delta Dental Plan that has contracted to provide dental coverage.

Restoration with subsequent crown
DeltaUSA:
General Policy - If a cast restoration is performed by the same dentist within 24 months of the placement of an amalgam or composite restoration, the Delta Dental payment and patient co-payment allowance for the amalgam or composite restorations will be deducted from the cast restoration benefit.

Delta Dental Plan of New Jersey:
General Policy - If a cast restoration is performed by the same dentist within 12 months of the placement of an amalgam or composite restoration, the Delta Dental payment and patient co-payment allowance for the amalgam or composite restorations will be deducted from the cast restoration benefit.

* As a reminder, the term "DISALLOWED" indicates that there is no Delta Dental or patient payment for this service.

Benefit coverage for these procedures may vary by contract.


Delta Dental Receives 'AA-' Rating From Standard & Poor's for Fifth Consecutive Year

Standard & Poor's (S&P) recently affirmed Delta Dental Plan of New Jersey's "AA-" counterparty credit and financial strength ratings for the fifth consecutive year. The company's capital position, earnings and business position were cited as the major rating factors. 

Delta Dental's continued high ratings are especially meaningful in the context of a challenging economy. The company has maintained a superior level of capital adequacy, which provides both flexibility and growth opportunities. Earnings, which increased 50 percent from the previous year, came from a balance of underwriting gains and investment income. 

"The brokers and consultants we work with feel confident when offering Delta Dental to their clients because of our financial strength and stability," said president and CEO Walter VanBrunt. "We have been operating in New Jersey for 35 years, and some of our sister Delta Dental Plans have been around for 50 years. We are proud of the fact that Delta Dental Plan of New Jersey remains one of the most highly rated dental plans in the country." 

In addition to the economic assessment, Delta Dental was also evaluated on its business position. It received a ranking of "good" based on a variety of factors including size, market share and competition. The company is the largest provider of group dental benefits in New Jersey and has the largest network in the state. Furthermore, through its access to the Delta Dental Plans Association's national network, Delta Dental also offers access to the largest dental network in the country. 

"As a single-line carrier, our expertise remains focused on offering the best quality dental benefits to our clients," said VanBrunt. 

Studies show that dental coverage continues to be a popular benefit among employees, ranking second only to medical benefits. A properly designed benefits plan has the potential to positively impact the retention of valued staff. Delta Dental is able to offer a variety of programs that make it easy, affordable and convenient for employers to provide comprehensive dental benefits through a strong commitment to innovation and cost-sharing arrangements, and business partnerships with sister Delta Dental Plans. 

"Delta Dental's mission is to promote oral health to the greatest number of people by providing accessible dental benefit programs of the highest quality, service and value," said VanBrunt. "Continued strong S&P ratings affirm that we are a sound company to do business with."


Benefits Connection Spotlight: Keith Bohleke, Quality Dental Care

Quality Dental Care in Vineland, New Jersey, is one of the top 10 dental offices using Delta Dental's Benefits Connection. Benefits Connection allows dental offices to verify patient eligibility and benefits online. 

We recently asked Keith Bohleke, the office's insurance coordinator, why Quality Dental Care uses Benefits Connection.

"It's by far the quickest method for verification of patient eligibility and benefits," he says. "We can immediately obtain 90% of the information we require going online."

Bohleke started using Benefits Connection while working at another dental office. He's used it steadily since joining Quality Dental Care in February 2003. 

"It's especially useful when patients present at our office in an emergency situation," Bohleke adds. "Their situation deserves immediate attention. It's much easier and faster to go online to get the information we need. It allows our office to operate more efficiently, and patients appreciate the immediate response we can provide should they have concerns about coverage."

Benefits Connection is available 24 hours a day, seven days a week, at www.deltadentalnj.com; click "Dentists" and then the "Logon" button in the Benefits Connection Logon box. If you've never used Benefits Connection, click "Register Now" in the Benefits Connection Logon box to get started. To see what's available through Benefits Connection, click "Benefits Connection Demo" and try the online demonstration.


Tech-Niques: Understanding Your Internet Connectivity Options
By Linda Hetcher, Vice President Professional Services, Concurrent Technologies

Once you decide that the Internet will benefit your practice, the next question is, what type of connection should you use?

Most dental offices will have three options to consider:

  • Dial-up access, which uses a modem to send and receive digital data over a telephone line.
  • Digital Subscriber Line (DSL), which offers a higher speed connection than dial-up access and uses existing telephone wiring.
  • Cable, which provides high-speed connections using the cable network originally developed for transmitting television channels.

The chart at the end of this article compares the three options. 

For more information about Internet options, visit the following Web sites:

  • http://www.broadbandreports.com/, which provides information on price, availability, quality and reliability of various broadband (high speed) options.
  • http://reviews-zdnet.com.com/, which provides technology reviews and other information.

Most Internet Service Providers (ISPs) have Web sites, which include specific information about their services. Popular ISPs include:

The good news is that connection speeds are faster and ISP prices are lower than ever. Competition is fierce, and ISPs offer frequent promotions to lure new customers. Be sure to ask about any discounts, trials and a detailed explanation of the total package offered. 

Be aware that both DSL and cable connectivity have their own supporters based on their particular needs, preferences and past experiences. However, the business of providing and supporting connectivity services is moving toward standardization. 

As always, weigh the options available with respect to time vs. expense and also ask the necessary security questions, especially where the exchange of patient data is involved. 
Remember that no connection is 100% guaranteed secure. Password protection, firewalls and data encryption are critical when handling sensitive information.

Features Dial-up Access Digital Subscriber Line (DSL) Cable Modem
Configuration


Uses a standard phone line.


Uses existing telephone copper wire, twisted pair.
Uses existing cable coaxial or fiber from the cable company.
How it connects to Internet









Works like a phone except it's a computer-to-computer instead of person-to-person connection. You dial up an Internet Service Provider access telephone number to connect your computer to Internet.



Enables the user to take advantage of extra telephone line capacity (which regular telephone service cannot do) so you can use the Internet while also talking on the phone using the same line. The connection is "always on." Enables the user to take advantage of extra bandwidth available on TV cable to connect to the Internet. The connection is "always on."




Cost*




Cost of your monthly phone bill. Toll charges may apply if your Internet Service Provider is out of your immediate area.
Installation ranges from $100 to $300, plus monthly fees from $80 to $300 for business.

Installation ranges from $75 to $200, plus monthly fees from $80 to $300 for business.

Speed*










Slow; maximum speeds 56 Kbps (56,000 bits of data per second).








Very high speed compared to dial-up; generally 128 Kbps to 1.5 Mbps (1.5 million bits of data per second) for downloading. DSL comes in various "flavors," some of which make a difference in uploading vs. downloading speed.
Very high speed. The average is 500 to 700 Kbps for downloading. Cable companies can throttle or limit your speed.





Equipment required


Modem, computer, phone connection.


DSL modem (usually included as part of the installation), computer, DSL line. Cable modem, cable connection.


Availability




Wherever there is a telephone line. It is also possible to connect via a wireless cell phone connection. Although prevalent in some areas, DSL is not available everywhere.


Although prevalent in some areas, cable is not available everywhere.

Causes of performance degradation











Connection speed depends on the line quality. The modem tests the line and falls back to lower speeds if the line can't handle a faster connection.








DSL is distance-sensitive. The computer must be located no more than 18,000 feet (3.4 miles) from the provider's central office. Connection speed degrades with distance. Those located a mile from the central office will usually have a better quality connection than those 3 miles away. Up to 1,000 users can connect to the Internet through a single channel. Connection degradation occurs as the number of people sharing a channel increases.






*Cost and speed of each option are only estimates. The actual cost and speed depend on many factors, including your practice's ISP. You should ask prospective ISPs about expected costs and speeds for their plan.

Please note that Delta Dental is not guaranteeing or endorsing any of the ISPs mentioned. The article is for information purposes only.

Concurrent Technologies designs and develops custom Web-based interactive solutions for a diverse clientele ranging from Fortune 500 companies to non-profit organizations. In the business for over 18 years, Concurrent Technologies is a total solution provider (TSP) offering a range of services from e-business strategy to complete technology outsourcing. For more information, visit them at www.concurrenttechnologies.com or call 800-345-3895.


Delta Dental Donates to Three Clinics

In an ongoing effort to positively impact the state's oral health, Delta Dental Plan of New Jersey Foundation, Inc. recently made donations to the Ocean Health Initiatives clinic in Lakewood, NJ, the Dover Community Clinic in Dover, NJ, and the Northwest New Jersey Dental Coalition's UMDNJ (University of Medicine and Dentistry of New Jersey) Dental Center in Newton, NJ.

Ocean Health Initiatives
Delta Dental's grants have supported the clinic since 2001. In addition to offering dental care, Ocean Health Initiatives provides adult internal medicine, pediatric and OB-GYN services to thousands of people, ranging from newborns to seniors, who are otherwise unable to afford a visit to the doctor or dentist. The clinic also recently expanded its services to include behavioral health and podiatry care.

"Ocean Health Initiatives is such a valuable resource for this community. It is exactly the type of organization that our Foundation looks to support because they make a difference in so many lives each and every day," said Diane Belle, vice president, Delta Dental Plan of New Jersey Foundation, Inc. 

Several Ocean Health Initiatives staff members are bilingual, which is helpful for the significant number of Hispanic patients who rely on the clinic. Its downtown location also makes the clinic accessible for patients without a car or the means to afford public transportation.

Ocean Health Initiatives was originally part of the Kimball Medical Center, an acute care hospital serving Ocean County, until cuts in Medicaid and Medicare prompted directors to research alternatives. "We decided that we could expand our services and reach even more individuals by becoming a federally funded independent clinic," said Dr. Theresa Berger, executive director. In December 2003, the clinic began to operate independently, and in March 2004 it received federally qualified health center status.

"Government funding, as well as the corporate support we receive from companies such as Delta Dental, has allowed us to increase our hours, offer new services and receive enhanced reimbursements to help more patients get the medical attention they need," Dr. Berger said.

Dover Community Clinic 
The clinic provides low cost, high quality, culturally and linguistically appropriate medical and dental care to low-income families in Morris County and surrounding areas. Delta Dental's grant will be used specifically to support the clinic's dental initiatives.

The Dover Community Clinic was founded in April 1990 by Dr. Bob and Kay Zufall to provide primary care services. Today the staff is comprised of retired specialists in a variety of fields including urology, cardiology, ophthalmology and oral surgery. The staff dentist, who saw close to 1,250 patients last year, is on site about three days a week. Several staff members are bilingual, which is helpful for the largely Hispanic patient population.

"Delta Dental strives to increase access to care and improve oral health throughout the state," said Walter VanBrunt, vice president, Delta Dental Plan of New Jersey Foundation, Inc. "We support the Dover Clinic's outreach to this community and continue to provide financial assistance to ensure the continuation of the valuable services they deliver."

The biggest challenge the clinic faced early on was cancellations and "no-shows," until it began attaching a modest fee to their services. Patients are asked to make a contribution, based on a sliding scale according to ability, at the time they make their appointment. This helps the clinic to meet its goal of providing care and access to those who need it.

According to Kay Zufall, who serves as clinic administrator, "We offer traditional preventive dental services, but many low-income families don't seek dental care unless something actually hurts. We can do dentures, root canals, crowns, and oral surgery by referral. But part of our mission is to educate patients about the importance regular dental care plays in their overall health."

The clinic currently sees low-income patients from Dover, Morristown, Parsippany, Randolph and Rockaway. The clinic sometimes receives inquiries from patients outside the county. When that happens, staff members usually assist that individual in finding a clinic that's closer to home. The goal is not to take private patients away from practicing dentists, but rather to offer services to those who would otherwise go without care because they cannot afford it.

Zufall says that the clinic recently began working with the Wharton school system to focus efforts on treating children. The school nurse will do preliminary screenings and make referrals to the clinic based on individual need. The clinic hopes to expand this service to other local areas.

Newton Dental Clinic 
The grant will be used to support the continuation of preventive and restorative dental care for those in Sussex and Warren counties who are uninsured or rely on Medicaid for health care. Delta Dental's funds will be used to defray operating costs of the program and to provide services directly to patients.

Currently, there appears to be only one dentist in Sussex County and very few in Warren County who will accept Medicaid patients. According to NORWESCAP Perspectives of Low Income People in Northwest New Jersey, there are approximately 5,900 Sussex County residents and 6,700 Warren County residents who are below 100 percent of the poverty guideline ($17,650 for a family of four). Approximately 27% of Sussex County low-income residents and 38% of Warren County low-income residents cited dental care as an unmet need.

"It is part of our mission to support organizations that directly impact the oral health of underserved populations in New Jersey," said VanBrunt. "The Newton Clinic is a wonderful resource for families who are otherwise unable to afford adequate dental care." 
Patients are referred to the UMDNJ Dental Center in Newton by a number of sources, including the Bureau of Social Services; NORWESCAP; school nurses; Domestic Abuse Services, Inc.; the Division of Aging and more.

"There is a dire need in this community for the dental services our clinic provides," explained Deb Fisher, president of the Board of Directors for the Northwest New Jersey Dental Coalition. "We are fortunate to have a wonderful, state-of-the-art facility, but we rely on the support of organizations like Delta Dental to keep our doors open and provide access to dentists for those in need."


Submission of Claim Forms Checklist

Have you...?

Correct Date

  • Correctly and accurately reported every date that a dental service was performed on, or a dental procedure performed on more than one date was completed on?

Correct Treatment

  • Correctly and accurately reported each dental service or procedure that was rendered?

Coordination of Benefits

  • Correctly and accurately reported all other insurance carrier coverage and payments that cover these dental services, as well as your maximum allowable charges (MAC) under that plan?

Disclosure of Waiver

  • Legibly and conspicuously disclosed on the face of the claim form any intention to waive all or part of a patient's copayment responsibility?

Disclosure of Discounts

  • Correctly and accurately reflected any discounts extended to the patient for these services?

Disclosure of Coupon Use

  • Correctly and accurately reflected any reduced fees that resulted from the use of coupons?

Disclosure of "Free" Services

  • Correctly and accurately reflected only services actually being charged to the patient's ledger?

Services Not Performed

  • Performed every service or procedure that is being submitted for payment?

Identification of Appropriate Dentist

  • Correctly indicated both the billing dentist and the treating dentist's name and license number?

Barter

  • Correctly and accurately reported only the actual dollars being collected for the services on the claim form and not the value of any "barter" exchanged?

ADA Helps Kids Answer Question, "What Do You Want To Be When You Grow Up?"

The American Dental Association (ADA) has devoted part of its Web site to educating students about various dental careers. The site includes information about becoming a dentist, dental hygienist, dental assistant and dental lab technician.

The site includes details about each profession, the training required, career options, future opportunities and expected salaries.

For more information, go to www.ada.org/public/education/careers/index.asp.


Wanted: Used Dental Equipment for Clinics

Do you have used dental equipment that you no longer need? If it is still in working order, please let us know. The Delta Dental Plan of New Jersey Foundation funds several clinics that cannot afford to purchase equipment, and they would welcome the opportunity to upgrade their equipment at no cost. Please e-mail Diane Belle at dbelle@deltadentalnj.com.


Captain Supertooth Begins Tour in January, February

Delta Dental's Captain Supertooth rides again! To celebrate National Children's Dental Health Month, the caped superhero of dental hygiene will visit school children in January and February to promote the importance of early preventive dental care and teach them proper oral care. In addition, Captain Supertooth made 14 appearances in October 2004.

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.

Captain Supertooth visits schools armed with a larger-than-life-sized toothbrush and other fun props. During the 20-minute 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 their dentist for regular check-ups. The program is geared for children in kindergarten through second grade, and is provided by Delta Dental as a free public service.

Since the program began in 1990, Captain Supertooth has instructed nearly 41,000 schoolchildren about proper dental care. Captain Supertooth programs will take place at eight Connecticut schools in late January and 30 New Jersey schools throughout February.


Phone: (800) 735-3379

 
 
  © Copyright 2001-2010 Delta Dental of New Jersey, Inc. All Rights Reserved. Legal | Privacy