We are watching and feeling, along with you and the world, how Novel Coronavirus (COVID-19) is changing the way we all live and work. The health and well-being of Delta Dental providers, customers, enrollees and employees is our priority. We want to reassure you that we have developed a coordinated strategy across our organization to maintain our operations and address issues as the situation continues to evolve. We know this is incredibly disruptive to your practices and will have a profound financial impact on you and your staff. We are continuing to look for ways to support Member Dentists through the coming months and would invite you send your ideas by email to AskMark@DeltaDentalWA.com for our consideration.
We want to share some information about what we are doing at Delta Dental of Washington and provide links to valuable resources. We recognize that this is and will continue to be a very challenging time for our Member Dentists and we are committed to keeping Member Dentists connected to what’s happening at Delta Dental during this rapidly changing situation in our country. We will update the information on this page periodically as the situation and our responses develop.
Important Updates from Delta Dental of Washington (DDWA)
- We do not differentiate benefit coverage for a limited oral evaluation – problem focused (D0140) performed in-person or in a virtual environment (i.e. via teledentistry). The two CDT codes for teledentistry (D9995 and D9996) are administrative and, when used, would be reported only in addition to a procedure completed (e.g. a limited oral evaluation/exam) on that date of service.
CDT procedure code D9992 is defined as dental case management – care coordination, and should be reported only when assisting a patient’s decisions regarding the coordination of oral health care services across multiple providers, provider types, specialty areas of treatment, health care settings, health care organizations and payment systems. D9992 should not be reported for use of personal protective equipment. Submitting a claim for PPE with any procedure code is not billable to the patient.
Practice Reopening Support Program
- On May 29, we announced a new Practice Reopening Support Program (PRSP). This program was dedicated to helping Member Dentists offset costs associated with reopening. To learn more about the program, sign in to your account and read Mark Mitchke’s blog post: Practice Reopening Support Program.
Interim Policies and Guidance During the COVID-19 Pandemic
This is an unprecedented time for both Member Dentists and patients covered by Delta Dental of Washington (DDWA). As practices plan to re-open and dentists continue to treat urgent and emergency conditions, we’ve put together a list of interim policies and guidance to help answer your questions and expedite claim processing. In addition to these policies and procedures, we expect there will be situations in the months ahead where more policy exceptions may be made to adjust for ongoing changes in dentistry. We are committed to working with you and addressing extraordinary circumstances as they arise. Read more.
DDWA Financial Support Programs
On March 20, we announced the Delta Dental of Washington (DDWA) Independent Dental Practice Reimbursement Advance Program (RAP) and the DDWA Independent Dental Practice Assistance Fund (PAF). These programs provide financial support to Member Dentists during the COVID-19 crisis, and we accepted applications for both programs through April 15.
DDWA payments will continue to be deposited on Fridays.
- Direct Deposit/Electronic Funds Transfer (EFT) Payments: There will be no impact to EFT payments, you will continue to receive payments deposited into your account on Friday.
- Paper Checks: We have confirmed with our vendors that there will be no foreseeable delays in paper checks. Should you choose to move to direct deposit (our recommendation), please sign up here.
- Capitation Payments: DeltaCare contracted providers can expect their monthly capitation payments as usual.
Customer Service Representatives are available for your questions
- We have made considerable changes to our operations to protect employees and at the same time serve our customers. This includes, moving some staff to a disaster recovery site, instituting social distancing and testing remote work options. Aside from our call center, all other DDWA employees are working remotely.
- If we experience greater than normal absenteeism you may experience longer hold times, and longer turnaround time for claims.
- We encourage you to use our website, DeltaDentalWA.com/Provider, and our IVR to answer any routine benefit, eligibility or claim status questions. They are available 24 hours a day, 7 days a week.
Claims will continue to be processed promptly
- DDWA continues to meet all of our claims turnaround targets, paying claims in an average of 3.7 days after receipt of the claim.
- 90%+ of claim submissions are received electronically and more than 80% of those claims are processed automatically.
We are working proactively with Customers to maintain coverage for your patients
- COVID-19 is impacting all our group customers and their employees. We are working closely with our groups to ensure continued dental coverage for their employees.
- When we are past this crisis there will be considerable need for care that was postponed. We know that adults with dental coverage are 2.5 time more likely to see a dentist than uncovered adults so continuous coverage is a priority.
Confirmation of Treatment and Cost and Claim Submission Timelines (Predeterminations)
- We are working on extending the approved timeframe for Confirmation of Treatment and Cost (COTC) allowing those COTCs that were set to expire in March, April and May to be extended so that the preapproved treatments can be completed at a later date. We will share additional information soon.
- We are also working on extending the 180-day timely filing requirements, and will keep you updated as decisions are made.
- We expect that offices may continue to provide limited treatment, particularly emergency examinations via some form of teledentistry. Be assured that no additional teledentistry codes will be required for these claims. Submit the same Limited Oral Evaluation – Problem-Focused code (D0140) you would submit if you were performing an in-person emergency examination and it will be paid providing the patient has coverage/benefits available.
- We recognize you may be rendering emergency or urgent procedures during these times. To avoid uncertainty in trying to predict benefits with limited office staff, there is no need to submit a predetermination for emergency related services or to contact our customer service for approval for a patient in the chair. Please type “URGENT” in the comments section of your claim form to communicate this situation to us. Through May 31, 2020 we will waive clinical review of these claims and make payment according to coverage and benefits available.
- We will continue to evaluate these interim policies through the end of April
Please consider Electronic Submission for Claims, Attachments, and Membership Updates
The quickest, most reliable way, to send claims and update your information with us is through our electronic resources.
- If you need to update your information with us, please visit our forms page. Almost all membership updates, can be completed fully online through DocuSign.
- We partner with many vendors that enable us to receive electronic claims and attachments. These include NEA FastAttach, Emdeon, TESIA, DentalXChange, and more. We highly encourage you to submit all claims, and attachments, through these electronic methods. This will ensure the quickest processing time and eliminate any delay that may occur through postal mail.
Working with other Delta Dental organizations
We are in close contact with other Delta Dental Member Companies across the country to identify any disruptions in service and how best to remedy them. To date, all Delta Dental Member Companies are operating, and we are not anticipating delays. As with DDWA, the quickest, most reliable way, to send claims and work with other Delta Dental Member Companies is through their electronic channels. We will keep you informed if there are any significant disruptions in service.
American Dental Association (ADA)
The American Dental Association has many resources available to dentists surrounding what to do in your practice.
ADA Coronavirus Resource Center
Washington State Department of Health Updates (WA DOH)
As the situation rapidly evolves, the Washington State Department of Health is the best resource for staying connected with current changes in our state. This includes some resources to provide to your patients, posters that may be helpful in your office, and up to date information regarding Personal Protective Equipment (PPE) in Washington.
Please check for updates regarding requested action to postpone elective and non-essential dental procedures.
WA DOH Healthcare Provider Resources
COVID-19 Resource Page
Resources for Washington Businesses and Workers
As a small business owner in Washington state, we understand this impacts you and your employees. This page shares information about financial resources and available options for small business owners and workers. This link includes information for how employees can apply for unemployment benefits during episodic layoffs and how you may retain highly trained staff if unemployment is sought.
COVID19 Resources and Business Owners
COVID-19 Webinar from university of Washington School of Dentistry
The University of Washington School of Dentistry is hosting a free webinar this Friday, March 20th. The course is titled “COVID-19 and the Dental Provider: Clinical Protocol Suggestions from the University of Washington School of Dentistry.” To register, and learn more, click here.
Best Practices in working through COVID-19
DDWA is not in a position to provide counsel on how best to manage your practice in these unique times but we can supply a list of best practices we have received and researched that you may find helpful as you make decision for your practice, staff and patients.
Protecting patients and staff
- Pre-screen patients by phone prior to the visit by asking about recent travel history and current health. Specific COVID-19 symptoms are fever, coughing and shortness of breath. If the patient reports these symptoms, they should be referred to their primary care physician.
- Ask patients if they have been out of the country in the past month and reschedule if they have.
- Email paperwork to be completed before arrival.
- When possible, ask patients to remain in their cars instead of coming into the waiting room. Notify them by cell phone when their treatment room is ready.
- Minimize the number of patients in the reception area and maintain space between patients per CDC guidelines.
- Take temperature of all patients immediately upon arrival.
- Have patients wash hands in the operatory and rinse with 1% hydrogen peroxide solution.
- Clean and disinfect public areas frequently, including door handles, chairs and bathrooms.
- Remove all reading materials and children’s toys/books from waiting rooms.
- Ask patients to brush before coming to appointments and remove all disposable toothbrushes, floss and mouthwash from restrooms.
Dealing with COVID-19 exposure in your practice
Should someone in your office be exposed or test positive for COVID-19 , below are some best practices. Since recommendations may change as additional information becomes available it’s a good idea to check the CDC website for COVID-19 updates. The page for Healthcare Personnel with Potential Exposure to COVID 19 is particularly helpful.
- Employees with any symptoms or who have family members with symptoms should not report to work and remain quarantined for 14 days after last exposure and until all symptoms have subsided.
- If it is determined the staff came in contact with a patient who tested positive for COVID19 staff should quarantine for 14 days after last exposure, the office should be thoroughly disinfected prior to seeing additional patients.
- If a staff member is tested positive for COVID 19 all staff and patients that visited your practice should be notified and quarantined for 14 days after last exposure.