Annual DDKS Membership Meeting

July 02, 2019

All Delta Dental of Kansas (DDKS) Member Dentists are invited to attend the DDKS Annual Membership Meeting on Saturday, August 10, 2019, at 8:30 a.m. at the DDKS Corporate Headquarters, 1619 N. Waterfront Parkway, Wichita, KS 67206. Registration is not required.

During the meeting, a participating dentist will be elected to the DDKS Board of Directors. A Nominating Committee was appointed by the DDKS Board Chair, as required by the DDKS Bylaws. The Committee met on June 20 and nominated Dr. Patrick Moriarty to succeed himself for another four-year term on the DDKS Board of Directors. Additional nominations for the vacancy may be made by written petition containing the name nominated, signed by at least ten (10) members in good standing, and delivered to the DDKS Chairperson of the Board at least five (5) days prior to the Annual Meeting at the address below:

Dr. Alan Marcotte, Board Chair
Delta Dental of Kansas, Inc.
P.O. Box 789769
Wichita, KS 67278-9769

Tips to Submit Multi-Option & Multi-Phase Pre-Treatment Estimates

July 02, 2019

A Treatment Plan With Multiple Treatment Options:

When submitting pre-determinations (or pre-treatment estimates) with multiple treatment options for your patient, submit each different treatment option on a separate claim form so that each pre-determination is processed independently. Add comments in the remarks section on the claim form noting treatment option #1, treatment option #2, etc. When you receive your pre-determinations back from us, you should see reference code 937 - optional treatment plans were submitted. Only one of the treatment plans will be allowed.

A Treatment Plan With Multiple Sequential Phases:

In order for a treatment plan with multiple phases to process chronologically, submit the different phases of the treatment plan on separate claim forms indicating the phase number in the remarks section (i.e. Phase 1 of 3, Phase 2 of 3, etc.). If you try to submit a multi-phase treatment all on one claim form, the procedures will automatically re-organize in numerical order by ADA codes instead of the intended treatment order.

Following these helpful tips should lead to a more efficient and accurate predetermination experience for your office.

Have additional questions? Contact your Professional Relations Representative.

Dental Claim Submission Tips

July 01, 2019

Updated ADA Claim Form Available Here:

The ADA recently updated their dental claim form. You can find a copy of the updated form on the Forms page by selecting the button below, or by logging in to your dentist account and visiting the Documents and Dentist Handbook section.

Access Forms

Tax Identification Number (TIN)

Submit all claims using the billing dentist/dental entity TIN.

If there is a change to the TIN or the name associated, please notify us so we can complete the TIN change on our end as well. It's important to submit the correct TIN based on the date of service. Any claims with a date of service prior to the TIN change should be submitted using the old TIN, and any claims submitted with a date of service after the TIN change should be submitted using the new TIN.

National Provider Identifier (NPI)

The ADA dental claim form provides space for both the NPI Type 2 (business) and the NPI Type 1 (individual). If your office is registered for a Type 2 NPI, please input it in box 49 of the claim form. If no Type 2 NPI is available, leave box 49 blank. Always include the treating dentist's Type 1 NPI in box 54. Making sure your NPI is in the correct place on the claim form can prevent claims processing delays and denials. For more information, or to manage/apply for your individual or organizational NPI, visit nppes.cms.hhs.gov.

Treating Dentist and Location

The name, NPI Type 1 and License Number of the treating dentist must be included in the Treating Dentist and Treatment Location section of the ADA claim form.

The only exception to this is when a substitute dentist is filling in for a dentist who is absent from his/her practice due to illness, injury, birth of a child, etc. (locum tenens).

The owner's name should never be substituted for the name of the dentist who actually performed treatment on the patient. The treatment location should not reflect the home office or billing office unless it reflects the actual place of treatment.

D0145 Processing

July 01, 2019

D0145 - Oral evaluation for a patient under three years of age and counseling with primary caregiver

Descriptor: Diagnostic services performed for a child under the age of three, preferably within the first six months of the eruption of the first primary tooth, including recording the oral and physical health history, evaluation of caries susceptibility, development of an appropriate preventive oral health regimen and communication with and counseling of the child's parent, legal guardian and/or primary caregiver.

 

D0145 is not identified as either comprehensive or periodic and can be used as an initial visit with the child as well as on subsequent visits that include an oral evaluation. This code is appropriate as long as the child remains under the age of three and includes preventive counseling provided to the primary caregiver. Otherwise, D0120 is used when no counseling is provided to the primary caregiver during the visit.

If D0150 comprehensive oral evaluation new or established patient is submitted on a claim for a patient under the age of three, you will receive a response on the remittance advice stating “Patient is over/under the age limitation allowed for this procedure”. A new claim is required that lists the correct ADA procedure code.

Please note, we are currently working on updating our system process so that in the future, we will automatically benefit D0145 when a claim includes D0150 for a child under the age of three.

DDKS Quarterly Reminders - June 2019

June 30, 2019

The Delta Dental of Kansas offices will be closed

July 4 - Independence Day

September 2 - Labor Day

 

Upcoming Events

Delta Dental of Kansas Annual Meeting for Participating Dentists:

8/10/2019 - Wichita, KS (8:30 a.m.)

Understanding Dental Insurance Seminar Opportunities:

9/6/2019 - Wichita, KS (9 a.m. - 12 p.m.)

9/6/2019 - Leawood, KS (9 a.m. - 12 p.m.)

Registration and more information available here.

Dentist Nominating Committee

May 30, 2019

Each year, the Dentist Nominating Committee recommends a candidate for election to the Delta Dental of Kansas' (DDKS) Board of Directors. Dr. Alan Marcotte, Chairman of the DDKS Board, appointed Dr. Mark Edwards to chair the Dentist Nominating Committee. Nominations may be submitted to Dr. Mark Edwards at:

P.O. Box 789769

Wichita, KS 67278-9769

 or

 pr@deltadentalks.com

Interested parties will be asked to meet with the Nominating Committee at DDKS headquarters (1619 N Waterfront Parkway, Wichita, KS 67206) on June 20, 2019 at 2:00 p.m.

The election will be held at the DDKS Participating Dentist Annual Meeting on Saturday, August 10, 2019 at 8:30 a.m. at the Delta Dental of Kansas Office (1619 Waterfront Parkway, Wichita, KS).

Delta Dental of Kansas Welcomes Preddis L. Sullivan, DDS, Executive Vice President and Dental Director

March 29, 2019

Dr. Sullivan assumed his role over Professional Services on January 25, 2019 reporting to Michael Herbert, President and CEO of Delta Dental of Kansas. Dr. Sullivan has executive oversight of Professional Relations and Professional Review and is responsible for setting clinical policies, and overseeing network development, utilization and quality management.

Dr. Sullivan’s career is extensive. He most recently served as the Chief Dental Officer at Envolve Dental. Previously, he served as Director of Professional Services for Delta Dental of California, Dental Director/Clinical Director at Blue Shield of California, Chief Dental Officer at PacifiCare Dental and Vision, as well as Vice President of Sales and Professional Relations at United Concordia Companies, Inc.

Dr. Sullivan received his DDS from the University of Illinois at Chicago College of Dentistry, and his MBA from the University of Illinois, Chicago. Dr. Sullivan owned and operated a dental practice that focused on treating patients with obstructive sleep apnea and TMJ disorders. He is currently licensed to practice dentistry in 11 states, including the state of Kansas.

“We are extremely happy to have Dr. Sullivan join our DDKS family,” said Michael Herbert. "His breadth of experiences will help Delta Dental remain the top dental carrier in the state.”

Regional Dental Consultants Wanted

March 20, 2019

Delta Dental of Kansas is looking for Participating Dentists interested in becoming Regional Dental Consultants.

Delta Dental of Kansas obtains second opinions through its Regional Dental Consultant network. A Regional Dental Consultant conducts clinical examinations, prepares objective reports of dental conditions, and evaluates treatment that is proposed or has been provided at the request of Delta Dental of Kansas. Interested candidates must be a Participating Dentist with Delta Dental of Kansas. It is our goal to have Regional Dental Consultants in all areas of the state.

If you are interested in being a Regional Dental Consultant, or have additional questions regarding the opportunity, please send inquiries and resumes to pr@deltadentalks.com.

Thank you for your consideration.

Online Dentist Account Updates

March 06, 2019

Addition of Termination Date to Patient Benefits

When we are aware of a Delta Dental of Kansas member's upcoming termination date, we will provide that information within the Dentist Account.

Patient Enrollment Period: 11/1/2005 - 5/1/2019

If there is no known termination date, you will only see the enrollment start date.

 

Ability to View Current Benefits Near Plan Year End

In the past, when viewing your patient's benefits near the end of their plan year, your patient's benefits would reset a few weeks before the actual end of their plan year causing confusion.

We have updated your online dentist account experience so you will only see your patient's current benefits.

DDKS Quarterly Reminders - March 2019

March 01, 2019

The Delta Dental of Kansas offices will be closed

May 27 - Memorial Day

July 4 - Independence Day

 

Upcoming Events

Understanding Dental Insurance Seminar Opportunities:

6/7/2019 - Wichita, KS (9 a.m. - 12 p.m.)

6/14/2019 - Leawood, KS (9 a.m. - 12 p.m.)

Registration and more information available here.

Contact Us

For more information on becoming a Delta Dental participating dentist, contact Delta Dental of Kansas’ Professional Relations team at 800-733-5823, email PR@deltadentalks.com, or fill out the form below.

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