Delta Dental of Kansas (DDKS) Participating Dentist Handbook

The dentist handbook is an extension of the Participating Dentist Agreement and is designed to provide important information related to the general processing policies and guidelines for all ADA CDT procedure codes, along with other helpful information such as definitions, submitting claims, appeals and using electronic services.

The 2020 Dentist Handbook will be available online shortly. To access, log in to your dentist account at DeltaDentalKS.com/Dentist and click on the Documents & Dentist Handbook section.

Log in to your dentist account to view the 2020 Dentist Handbook

Delta Dental PPO^TM Fee Schedule

Delta Dental of Kansas wishes to thank you for your continued participation in our Delta Dental Premier^® and/or Delta Dental PPO^TM  networks.

Please consider this an official notification that the 2020 Delta Dental PPO Fee Schedule will be available online by December 23, 2019. To access the schedule, log in to your dentist account at DeltaDentalKS.com/Dentist and click on the Documents & Dentist Handbook section. You may also access your Detailed Dentist Snapshot (DDS Report) in the reporting section of the Kansas Provider Toolkit. 

There are no changes to the 2020 Delta Dental Premier nor the Delta Dental PPO fee schedules with the exception of these 3 procedure codes: D4346, D9945 and D9946. As you have previously been informed, several enhancements were introduced designed to benefit DDKS members (your patients) that will become effective upon employer group renewal starting January 1, 2020 for risk (fully-insured) groups that choose them. (Please review those enhancements here). 

Please note Delta Dental’s PPO program is an optional network for Participating Dentists who signed a supplemental agreement. Contact your local Professional Relations Representative if you would like to participate in and/or learn more about the PPO Network or send an email requesting information to pr@deltadentalks.com.

Log in to your dentist account to view the 2020 PPO Fee Schedule

CDT Code Additions, Revisions & Deletions

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Delta Dental of Kansas (DDKS) Processing Policy Changes

The American Dental Association has published the new procedure codes for 2020. Changes include: 37 new codes, 6 deleted codes, 5 revised nomenclatures/descriptors and 15 editorial actions that clarify without changing the CDT code entry's purpose or scope.

To order CDT 2020 items, visit adacatalog.org or contact the ADA at 800.947.4746.

Download Flyer

Delta Dental Individual & Family^TM Dental Plans - 2020 Plan Updates

What's Changing?

• Platinum plan rates are changing
• All four plan options will include the new Right Start 4 Kids^SM program
• Pre-determinations are no longer required

2020 brochures for our individual and family plans have been mailed out to all Participating dental offices. These updated brochures have the rates for 2020. Please use the 2020 brochures and discard the old brochures.

Any enrollee who enrolls AFTER November 25, 2019 will have a 1-1-20 start date, and will have the 2020 rates.

To order more brochures, please contact pr@deltadentalks.com.

Click here for more information on DDKS' Individual and Family plans

Through Delta Dental of Kansas' Matching Gift Program, Participating Dentists' approved charity donations may be matched up to $100.

Please submit your Matching Gift Application and receipt to DDKS' Community Benefit department at corpcomm@deltadentalks.com.

Learn more and download the Matching Gift Application

Please review the 2020 plan changes for Employer Risk Groups.

Please review the processing policy changes starting 1/1/2020.

Download Flyer

Please verify patient coverage and benefits each time your patient seeks treatment at your office. You can easily check by logging in to your dentist account at DeltaDentalKS.com/Dentist. While we’ve included many of our large group benefit changes on the linked flyer, not all groups with dental plan changes have been listed.

Download Flyer

The Delta Dental of Kansas offices will be closed

December 24 after 12 p.m.; December 25 & 26 - Christmas

December 31 after 12 p.m.; January 1 - New Years

Upcoming Events

Stay up to date on events offered by DDKS at DeltaDentalKS.com/Register

Dental Office Changes or Updates? Please notify us when:

• New and/or change of physical or payment address(es)
• New and/or change of phone number(s)
• A dentist joining or leaving
• Closing of an office
• Tax information changes
• New and/or changed NPI information
• Retirement
• Sale or purchase of practice
• License status updates

At the end of December 2019, Delta Dental will no longer be partnering with Brighter as our dentist appointment scheduler. At that time, the “schedule an appointment” feature from Brighter on the online dentist search and our mobile app will no longer be available.

According to Brighter, your practice will remain registered on the platform and you can continue to manage patient appointments with other dental insurance carriers that have a relationship with Brighter. All currently scheduled appointments made via Brighter should remain in place.

Please contact us if you have any questions.

Each year Delta Dental of Kansas (DDKS) reviews potential policy and benefit changes for our members and groups. We would like to inform you of enhancements we will be offering on or after January 1, 2020 (at the group's renewal date). Please note which groups are affected for each enhancement below. If you have any questions, please reach out to your Professional Relations Representative.

Right Start 4 Kids^SM (RS4K)

This plan design enhancement removes the cost barriers for dental care for children 12 and under. If the group chooses this enhancement, the program provides children 12 and under 100% coverage, with no deductible, for all services covered under the plan, excluding orthodontics, when a Participating Dentist is seen. If an out-of-network dentist is seen, the underlying contract applies including waiting periods, deductibles and coinsurance levels. Please verify the member's coverage and eligibility date.

Groups affected: Offered to all Risk groups; all Individual policies.

Implementation: On or after January 1, 2020. Please verify member's coverage and eligibility date. Coverage is based on current group or individual contract.

Unlimited Cleanings

If the group chooses this enhancement, members will be allowed unlimited cleanings. Covered codes include D1110, D1120 and D4910 (for D4910, previous surgical/non-surgical history is required). Please verify the member's coverage and eligibility date.

Groups affected: Offered to all Risk groups.

Implementation: On or after January 1, 2020. Please verify member's coverage and eligibility date. Coverage is based on current group contract.

Annual Maximum Increase to $1,500

If the group chooses this enhancement, annual maximums currently below $1,500 will be increased to an Annual Maximum of $1,500. Please note, groups with a buy-up option will not have an Annual Maximum increase on the base plan. Please verify the member's coverage and eligibility date.

Groups affected: Offered to all Risk groups. Groups with a buy-up plan option will not have an Annual Maximum increase on the base plan option.

Implementation: On or after January 1, 2020. Please verify member's coverage and eligibility date. Coverage is based on current group contract.

Have additional questions? Click here to contact your Professional Relations Representatives.

Mandatory Pre-Determination Removal:

Implementation: January 1, 2020

Groups affected: All Risk groups; all Individual policies.

Effective January 1, 2020 for Individual policies and all Risk groups, Pre-Determinations will no longer be mandatory for any code.

Scaling and Root Planing (Code D4341):

Implementation: January 1, 2020

Groups affected: All groups.

Effective January 1, 2020 for all groups, when scaling and root planing (SRP) is performed in 3 or more quadrants on the same day, the claim will be referred to dental consultants for review.

Review Criteria:

• There must be 4 or more teeth in a quadrant.

• Exposure of cemental surfaces of the root is necessary for root planing, therefore radiographs must show the crest of the alveolar bone more than 1.5 - 2.0 mm apical to the CEJ.

• Submit periapical or bitewing radiographs and periodontal chart documenting probing depths, amount of attached gingiva and clinical attachment levels.

Please Note: Panoramic radiograph (D0330) will no longer be accepted for SRP claims documentation and determination. According to the American Academy of Periodontology, panoramic X-rays have limited value in the diagnosis of periodontal disease (Delta Dental Dentist Handbook, Pg. 67).

General Anesthesia and IV Sedation (Codes D9222, D9223, D9239, & D9243):

Implementation: January 1, 2020

Groups affected: All groups.

Effective January 1, 2020 for all groups, if general anesthesia and IV sedation are performed in excess of one hour, the claim will be referred to dental consultants for review.

Review Criteria:

• Submit anesthesia record showing start/stop times, vitals checked, anesthesia used, etc.

• Submit chart notes which should include procedure(s) performed and, if necessary, the reason/necessity for additional anesthesia.

Fabrication of Athletic Mouthguard (D9941):

Implementation: January 1, 2020

Groups affected: All Risk groups; all Individual policies

Effective January 1, 2020 for Risk groups and Individual policies, D9941 will be a covered Major service under the group's plan, excluding plans that do not have coverage for Major services. The underlying contract, age limitations and frequency limitations apply.

Have additional questions? Click here to contact your Professional Relations Representative.

Delta Dental of Kansas Board of Directors has new Chair and Vice Chair

Gary Yager has been named Chair of the Delta Dental of Kansas board of directors.

Dr. Brick Scheer has been named Vice Chair of the Delta Dental of Kansas board of directors.

Dr. Patrick Moriarty to continue to serve on Delta Dental of Kansas Board of Directors

During the 2019 Annual Meeting held on August 10th, Dr. Patrick Moriarty was reelected to the DDKS Board of Directors for another four year term.