As a reminder, Delta Dental requires that the treating dentist’s (the dentist completing the service) license number and type 1 NPI (National Provider Identifier) are listed on all claim submissions. The treating dentist is responsible for ensuring the medical necessity and appropriateness of the services.
As the dental marketplace continues to change, hiring associates and having a multidentist practice is increasingly more common. Delta Dental receives frequent inquiries regarding the correct way to bill for services.
As such, it is important to notify Delta Dental when an associate, partner or temporary dentist is hired. We will update our claims processing system and associate the treating dentist to the billing entity or corporation so that claims are processed appropriately. There may be instances where the practice owner may be participating with Delta Dental, but the associate is not participating. Since reimbursement rates differ for participating (in-network) providers versus nonparticipating (out-of-network) providers, this can cause confusion for both the practice billing administrator and the patient. The claim can be processed and paid differently for nonparticipating providers, ultimately affecting the patient’s financial responsibility.
Recent versions of the American Dental Association (ADA) claim form provide clearly identifiable areas to report the billing entity and treating provider information. It is very important that dental offices report accurate treating provider information on the claim form. It is considered unprofessional conduct and fraudulent billing to do otherwise.
We do not recommended using older versions of the claim forms, as they do not provide adequate areas of the reporting treating provider information. Using these older claim form versions does not dismiss an office requirement to report accurate treating provider information. New claim forms may be obtained through the ADA.
Every three years, Delta Dental is required to recredential network dentists as part of your Delta Dental participating provider agreement. Please make sure you return all required recredentialing documents to Delta Dental as instructed in the recredentialing packet that you receive via email or mail. Failure to return this form will result in terminated participation in the Delta Dental networks.
As a reminder, the Delta Dental Dentist Handbook contains all of the information your dental office staff needs to know about Delta Dental of North Carolina’s standard claims processing guidelines and administration policies. Please click here to download a copy for your office today.
It just got easier for patients to make appointments with you. Delta Dental and Brighter are working together to connect patients and participating providers through the Delta Dental online directory. Activate Brighter Schedule today, and grow your practice, completely free. Download the resource PDF.
DDNC adds more than 50,000 subscribers for January 1, 2018
Delta Dental of North Carolina is proud to announce the addition of the following large groups, effective January 1, 2018, bringing more than 50,000 new subscribers to the Delta Dental family. The list below does not include the numerous small-market groups and individual subscribers that are also joining the Delta Dental family in 2018.
Group Name and Number of Eligible Subscribers:
Volvo Group North America: 12,000
Wake County Public School System: 16,000
JELD-WEN, Inc.: 6,500
Union County Public Schools: 3,000
Delta Dental of North Carolina was a proud gold sponsor of the North Carolina Dental Society (NCDS) Annual Session held in Myrtle Beach, South Carolina. The Annual Session was a huge success, gathering nearly 900 dental professionals who practice across the great state of North Carolina. Our team (pictured here, left to right: Emily Bowling and Rosanna Arrington) had a great time meeting and speaking with all of the dentists who attended. We look forward to seeing you all again next May!
Delta Dental of North Carolina’s professional services representatives are in the field, visiting offices and creating lasting partnerships. Since January, our representatives have visited more than 500 offices from the mountains to the coast. Our representatives strive to be available to you for timely support and issue resolution. Our locally based professional services representatives have assigned territories to better serve your needs. If you are not sure who your dedicated representative is, check out the territory map (https://www.deltadentalnc.com/MediaLibraries/Community/DDNC-PR-Rep-Territory-Map.pdf)
on our website. We appreciate all you do to support our great mission of improving the oral health of the communities we serve. We sincerely value your partnership in care of all North Carolinians.
The Delta Dental Foundation awarded a $15,000 grant to the High Point Regional Health Foundation, which allowed for the creation of an interactive exhibit to help educate children on the importance of oral health.
Delta Dental of North Carolina established the Delta Dental Excellence Scholarship with the Wake Tech Foundation to assist students in the college’s dental hygiene and dental assisting programs. Delta Dental of North Carolina will award $5,000 annually, to be divided evenly among eight scholarship recipients.
If your practice is changing email addresses, please let us know. Please send your name and new email address here.