MOUTH MATTERS by Delta Dental of Minnesota

December 2014

Participating Dental Provider Policies and Procedures

Mouth Matters is published by Delta Dental of Minnesota for participating dental offices. Send article ideas, questions or comments to editor@deltadentalmn.org.© 2014 Delta Dental of Minnesota and its affiliates. All rights reserved. Delta Dental of Minnesota is an authorized licensee of the Delta Dental Plans Association of Oak Brook, Illinois.www.deltadentalmn.org DDMN.i115.14

This IssueCDT Codes Updates

Participating Dental Provider Policies and Procedures

Required Fraud, Waste and Abuse Training

Business Updates

In the Community

Delta Dental of Minnesota is e-friendly!To receive the next issue by email, please provide your email address and office name to: ddmnnetworkservices @deltadentalmn.org.

The Board of Directors reviewed and approved edits to the Participating Dental Provider Policies and Procedures this month. The new document will be mailed to you by 01/01/2015, but will not take effect until 05/01/2015, to allow for the required 120-day notice. This document is part of the participating dentist contract(s) and applies to all networks that Delta Dental of Minnesota administers, except for the SingularDental® Network.

The changes include updates and information regarding the following:

§ Office of the Inspector General (OIG) sanctioned providers

§ MinnesotaCare Tax versus sales tax

§ Discounts/Coupons

§ Clarifications to definitions and terms

SocialGet connected to relevant and timely resources for oral health and wellness through Delta Dental of Minnesota social media channels! You can engage with educational videos, infographics related to oral health, upcoming events and the latest health and wellness news. Content includes topics on diabetes, pregnancy and heart disease as related to both oral health and overall health.

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The American Dental Association (ADA) has finalized the CDT 2015: Dental Procedure Codes (The Code).

The Code is annually updated to reflect changes in dental procedures accepted by the dental community.

As a result of the new Code, Delta Dental of Minnesota has updated our Processing Policies. The 2015 Processing Policies will be available on the secure portal on 01/01/2015.

With all the new code changes, we recommend that dentists/dental offices verify covered services for patients before rendering treatment. Details of individual coverage can be verified

by calling the customer service phone number listed on the back of the patient’s card.

Accurate coding promotes faster claim processing and fewer errors, so Delta Dental recommends that each dental office have a current copy of The Code.

To order a copy of The Code, visit www.adacatalog.org.

CDT Codes Updates

Code Change Summary § 16 new codes § 52 revised codes § 5 deleted codes

§ 10+ actions affecting subcategories or descriptors

Friendly RemindersRequired Fraud, Waste and Abuse Training:You should have received a letter and packet of information in November with regard to the Centers for Medicare and Medicaid Services (CMS) required Fraud, Waste and Abuse training. This training is required for anyone who provides services or care to Medicare Advantage Enrollees on behalf of a health plan.

If you and your staff have already completed the training and returned the documents to Delta Dental of Minnesota Professional Services, we appreciate your prompt attention to this requirement. It is a CMS requirement that you, and all of your employees complete the required compliance training by 12/31/2014.

Upon completion, please sign the Attestation Statement form, complete the Training Log and the Facility Profile Form. The completed and signed documents may be mailed in the self-addressed stamped envelope, which was included in your packet. As an alternative, you may fax the three completed documents to: (612) 351-5195.

Filing Fees: Delta Dental of Minnesota recommends that you submit your current fees electronically by visiting: www.deltadentalmn.orgor print and submit the form by mail or fax to: (877) 631-8954.

Change of Information:Have you recently changed your tax ID, phone number or address? Delta Dental of Minnesota recommends that you notify us of the change, preferably 30 days in advance. You will need to provide a W-9 form and a letter indicating the changes. We also recommend that you do not file claims until you have confirmed with Delta Dental of Minnesota that the change has been updated in our system. Delta Dental of Minnesota will forward the change to all other Delta Dental’s via the National Provider File.

At Delta Dental of Minnesota, we pride ourselves on our commitment to outstanding customer service and our dedication to our providers. As part of our commitment to our providers, we have continued to grow our team of talented Professional Services employees. Our recent growth has included the hiring of our Vice President of Dental Services, Dr. Sheila Strock, to lead the professional services team in the management of the network of dental providers.

Dr. Strock brings more than thirty years of experience in the dental field to Delta Dental of Minnesota, including previous management positions with the American Dental Association and Delta Dental of California. Additionally, Dr. Strock is very committed to leading research efforts to better educate our community on the association of oral health and overall health.

Get to Know Our Team

“I am so pleased to be a part of the Delta Dental of Minnesota team.

Our team is dedicated to working with you, our providers, and your offices to fulfill our mission of improving health through oral health. It’s an exciting time in dentistry! One of the key areas of interest to me is the integration of medical with dental; the oral-systemic connection.

We look forward to working with you this upcoming year and we will continue to strive to align our focus on the mouth with systemic health.” – Dr. Sheila Strock

QUESTIONS?Contact Delta Dental

of Minnesota Professional Services:

800-328-1188 ext. 4170

Did You KnowDelta Dental of Minnesota is 1 of 39 Delta Dental member companies across the country. Each plan operates separately, but all are supported and advised by the Delta Dental Plans Association, out of Oak Brook, Illinois.

The Delta Dental Plans Association offers uniform policies and procedures that help set standards across all member companies. However, each Delta Dental member company has a different claims processing system and general business standards. Please remember to identify the various Delta Dental’s that you are working with, as most plans have customers spanning across the country. Your participating provider agreement is managed by your home state, or in some cases, the Delta Dental that manages your state.

Delta Dental of Minnesota manages Minnesota and North Dakota, along with Nebraska through Delta Dental of Nebraska. Any questions you have regarding your participation should go to your managing Delta Dental.

EventsWe will be back at the Star of the North annual meeting on April 23-25, 2015. Visit us at our booth in the exhibit hall. For more information on the event, visit: http://star.mndental.org!

STAR OF THE NORTH

SPONSORSHIP

Throughout the past year, we hosted several dentist appreciation events, including complimentary tickets to Minnesota Swarm and St. Paul Saints games. This is a chance for us to thank you for your partnership, so thank you for attending!

DENTIST APPRECIATION

EVENTS

We held our first annual Delta Dental of Minnesota Symposium (formally the Forum) in October at the University of Minnesota. You can still watch this year’s keynote Speaker, Dr. Denis Lynch’s presentation titled: Oral Manifestations of Systemic Diseases here: www.deltadentalmn.org/dentalProfessionals. Stay tuned for details on the 2015 Symposium!

SYMPOSIUM 2014

Effective 01/01/2015, UCare dental plans for Commercial, Medicaid and Medicare products will be administered by Delta Dental of Minnesota.

The following UCare Customer Service numbers have been established based on the plans. Please refer to the member ID card for the correct phone number:

UCare MN Health Care Programs: 651-768-1415 855-648-1415 toll-free (members use CivicSmilesSM Network)

UCare for Seniors Medicare Programs: 651-768-1416 855-648-1416 toll-free (members use CivicSmiles Sr. Network)

UCare Choices Programs available through MNsure: 651-768-1417 855-648-1417 toll-free (members use CivicSmilesSM Network)

You can also contact Delta Dental of Minnesota Customer Service regarding benefit options.

Contact Delta Dental of Minnesota Professional Services at 800-328-1188, ext. 4170 for more information or if you’re interested in becoming a participating provider in the CivicSmiles and CivicSmiles Sr. Networks.

Claims with dates of service starting 01/01/2015 should be submitted with the member’s 11 digit ID number, which can be found on the member ID card. Submit claims electronically using the Delta Dental of Minnesota Electronic payer ID 7000.

Business Updates

Processed claims can be found on the Delta Dental of Minnesota website: www.deltadentalmn.org.

Note: History is not available on the website; please contact Customer Service regarding services previously benefited.

Delta Dental of Minnesota500 Washington Avenue South, Suite 2060Minneapolis, MN 55415

www.deltadentalmn.org

In the CommunityDelta Dental of Minnesota is committed to supporting initiatives that promote oral health, and in turn, improve the overall health and vitality of our community. We do this through the sponsorship of various events and initiatives throughout Minnesota.

Minnesota Mission of MercyDelta Dental of Minnesota Foundation was the presenting sponsor of the 2014 Mission of Mercy in Mankato this past July, which provided free dental care to thousands of Minnesotans.

For more information on our involvement in the Mission of Mercy event, visit: www.mndental.org/events/ mission-of-mercy/

§ ORAL CANCER AWARENESS WALK Delta Dental employees participated in the 2014 Oral Cancer Walk on October 19th in support of oral cancer research.

§ DIABETES EXPO On October 11, Delta Dental of Minnesota sponsored the American Diabetes Association Expo to educate and inform diabetics on the correlation between diabetes and periodontal disease.

§ CHILDREN’S DENTAL SERVICES DENTAL CLINIC EXPANSION The Delta Dental of Minnesota Foundation provided the funds for the Children’s Dental Services (CDS) dental clinic expansion in NE Minneapolis. CDS is committed to providing oral health outreach and education to families regardless of family income or background.

Follow us on Facebook to see our employees

in action in our

community!

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