I would like to extend a special thank you to the nearly 200 Participating Dentists that attended our Annual Meeting on Saturday, August 15th. I would also like to congratulate Dr. Nicholas Troilo on his election to the Delta Dental of Kansas Board of Directors. We are very pleased to have you as part of the Delta Dental of Kansas team.

2020 has been an unprecedented year and Delta Dental of Kansas remains committed to supporting you during these challenging times. As a reminder, our Dentist Support PPE Program remains effective through the end of 2020.

I look forward to the year ahead and on behalf of Delta Dental of Kansas I want to thank you for your partnership.

Sincerely,

Dentist Account Homepage Redesign

We've redesigned our dentist account homepage to make it easier to access the information you need:

• Check patient benefits and eligibility
• Retrieve Explanation of Payments (EOPs)
• Submit claims
• And more

Easily Search for Online EOPs

We have made it easier to search for your Kansas Explanation of Payments (EOPs) within your online dentist account. Some key improvements include:

• The dollar amount displayed in the "Amount" column will show the total deposit amount for multi-dentist or multi-location practices.
• Users now have the ability to hide and unhide processed EOPs by selecting the box in the "Hide" column. To view a previously hidden EOP, simply select "Show Hidden EOPs" above the listing.
• EOPs remain available online for 6 months (180 days) before they expire and drop from your EOP listing.
• For ease in finding a specific EOP, each column is sortable. Users can also search for a specific word, date, deposit amount or transaction number or check number by using the search box.

Log in to your online Dentist Account at DeltaDentalKS.com/Dentist.

Do you know what attachments we require when you submit a claim?

Delta Dental of Kansas is committed to making your claim submission experience as smooth as possible by limiting the amount of requests for attachments. To assist you during your next claim submission, please see our updated list of general guidelines for procedure codes that require attachments or other documentation.

Enroll in direct deposit and Delta Dental will send claim payments electronically to your designated bank account. Payments often can be in your bank account in as little as 48 hours when claims are submitted electronically. Direct deposit is a free service only available to Participating Dentists.

Click here to complete the direct deposit form. Direct deposit account activation typically takes 7-10 business days from registration.

In situations when a tooth does not have sufficient remaining tooth structure to support the planned restoration, the anatomical crown may need to be "built up" using a restorative material foundation. A Core Buildup is indicated for teeth with significant loss of coronal tooth structure due to caries or trauma in which insufficient tooth structure remains to adequately retain an indirect restoration.

Gordon Christensen DDS, MSD, PhD, ScD, regarded as one of the most renowned authorities on dental materials and clinical practice, has addressed these questions in several articles published over the years in the Journal of the American Dental Association. An assessment should then be made of the remaining tooth structure. If more than 50% of the prepped coronal tooth is missing and there is not at least a two to three-millimeter collar of sound tooth structure remaining at the gingival margin, a core buildup should be added.

The Delta Dental National policy states a core buildup is generally indicated if all of the following conditions are met:

1. A significant portion of tooth structure (50% or more) is fractured or carious
2. The preparation is at or below the gingival crest
3. Less than 3mm of sound dentin remains vertically above the preparation line in opposing walls where the crown margins will be located

DDKS requires a pre-op x-ray to be submitted with the claim to ensure the above criteria is met. Although not required, it is also suggested that an intraoral photo taken post prep be submitted in addition to the pre-op x-ray to help show the need for the core build-up if the pre-op x-ray doesn't demonstrate the above required criteria for a build-up.

Sources: Christensen, Gordon. Clinicians Report, August 2018, Volume 11, Issue 8

What Date do I Use When Submitting Multi-Stage Procedures?

Delta Dental of Kansas (DDKS) General Policies:

Multi-stage procedures are reported and benefited upon completion. The completion date is the date of insertion for removable prosthetic appliances. The completion date for immediate dentures is the date that the remaining teeth are removed and the denture is inserted. The completion date for fixed partial dentures and crowns, onlays and inlays is the cementation date regardless of the type of cement utilized. The completion date for endodontic treatment is the date the canals are permanently filled.

To avoid claim processing delays, we recommend:

• Posting the procedure on the patient ledger and collecting the patient’s estimated co-insurance on the impression date (recall from the handbook, that the patient cannot be charged up front for any amount which is anticipated to be paid by DDKS)
• Printing and holding the claim in a file until seat date
• Submitting the claim following delivery to the patient (in remarks box #35, include completion date to reflect the cementation or delivery date)

Nationally, Delta Dental member companies require that you submit all multi-stage procedures upon delivery. Orthodontic treatment is submitted on the date that brackets are bonded/cemented or the first aligners are delivered.

But What if My Patient Never Returns for Delivery?

You may believe that collecting from the insurance protects you if the patient never returns for their night guard, orthodontic appliance, denture, permanent crown, bridge or other lab-created device, however this is incorrect. If the procedure is never completed, which includes delivery to your patient, any insurance money received toward that procedure must be refunded.

If your patient agrees to services that take more than one appointment or for which you incur a lab bill, but the patient never returns for the final product, then the correct procedure code is the corresponding temporary or interim code - or you may need to use one of the miscellaneous codes. Always include a narrative for these situations.

Delta Dental does not provide coverage for incomplete services, but some temporary services are made patient responsibility depending on circumstances, so be sure to include those on your claim form. If documentation was not included on the original claim, appealing the claim with additional information such as chart notes and/or narrative may allow us to reprocess and deny to patient pay so that you can recoup your lab and material costs from your patient. Sometimes patients change their mind mid-treatment and that is why it is critical that you collect the patient portion on or before the date of impression.

Delta Dental of Kansas will be providing links to continuing education resources in addition to the events we host. Check our Events/CE webpage for additional resources as they are posted: DeltaDentalKS.com/Dentist/Events.

Saturday, August 15, 2020

8:30 a.m.

Via GoToWebinar

The DDKS Annual Membership Meeting will be held at 8:30 a.m. on Saturday August 15, 2020. Consistent with our commitment to providing a safe and healthy environment for our Members’ annual meeting, and in light of public health concerns surrounding the COVID-19 virus and possible governmental meeting restrictions, the DDKS Board of Directors voted to hold this year’s Meeting virtually via GoToWebinar.

To ensure a smooth and secure meeting, DDKS will be utilizing the services of an experienced outside company to conduct the meeting. Participation in this format will permit participants to both hear and see presentations as well as ask questions. Although many of us are now familiar with virtual meeting protocols, some brief guidelines regarding meeting format and participation will be outlined at the beginning of the meeting. Please login and join the meeting at least 15 minutes early to help facilitate a smooth meeting start at 8:30.  

Only Participating Dentists are eligible to attend and vote, and those who wish to attend must register for the meeting by noon on Friday, August 14, 2020. Registration is available by logging in to your online dentist account here. Each registrant must use their own individual email address. Upon successfully registering, you will receive a confirmation email containing your unique identification number and information about joining the webinar. If you do not receive a confirmation, please contact us at pr@deltadentalks.com.

Pursuant to the Bylaws, the purpose of the meeting is to receive the annual reports of the officers, elect a member to the DDKS Board of Directors, and transact such other business as may properly be presented. With respect to the Board election, a Nominating Committee was appointed by the Board Chair, pursuant to Article V, Section 7, of the DDKS Bylaws. The Committee met on June 23, 2020, and nominated Dr. Jeffrey Burkett for a four-year term on the DDKS Board of Directors. As of this date, Dr. Nick Troilo has also been nominated by petition. Additional nominations may be made via a written petition containing the nominee’s name, signed by at least ten (10) members in good standing, and delivered to the Chairperson of the Board at least five (5) days prior to the Annual Meeting at the following address: Mr. Gary Yager, Board Chair, Delta Dental of Kansas, Inc., P.O. Box 789769, Wichita, KS 67278-9769. 

Thank you and we look forward to your participation in the Annual Meeting.

The Dentist Support PPE Program was implemented on June 1, 2020 to help assist Participating Dentists with increased costs related to PPE from the COVID-19 pandemic. This program will remain in effect until December 31, 2020 (extended from July 31, 2020).

Important program reminders: 

• Payments will be issued monthly as a bulk payment for the total number of DDKS patient visits from the prior month (Checks will be mailed around the 15th of each month).
• Delta Dental of Kansas will pay participating dental practices in Kansas $10 per patient visit for patients that are DDKS covered members only.
• Participating Dentists will submit claims as usual (no special codes or notes needed).
• Claims must be received within 30 days of the date of service in order for DDKS to calculate payments.

The Dentist Support PPE Program is in addition to two dentist relief programs that were launched in April. The first program - our Dentist Relief Aid Program - distributed approximately $3 million in relief payments in April. The second program - our Dentist Advance Claims Payment Program - provided interest-free claims advance payments to assist Participating Dentists across the state with their practice. You are an important partner with us in improving the oral health of your patients. We are committed to supporting you, our group purchasers, our members and our employees during these unprecedented times.

We want to make sure we are communicating to your patients about dental benefits in a way that is easy to understand. As part of this effort, we have completely revamped our Explanation of Benefits (EOBs) to a more member-friendly format with easy-to-understand terms and language. Some key updates:

• A high level call-out section that will quickly tell the member what is being paid by their dental plan and what their share of the cost is.

• Links for patients to have easy access to all information related to their dental benefits plan including exclusions and limitations.

• A simplified claim detail chart.

• An added benefit summary section letting the member know how much of their deductible and annual maximum they have used to date.

• A clear call-out at the bottom of the page letting the member know how much of their Benefit Period Annual Maximum they have remaining to use.

• On the back of the new EOB, we’ve added helpful definitions, explanations of appeal rights in plain language, and more.

Next up, we will be updating the Explanation of Payments (EOPs) that are mailed to dental offices with checks.

What did our EOB used to look like? You can view an example of our old EOB here.

View New EOB Example