CDT code changes for 2016 include the addition of codes D9223 Deep Sedation/General Anesthesia and D9243 Intravenous Moderate (conscious) Sedation/Analgesia, plus detailed instructions on how to submit orthodontic claims.

Please review the 2016 CDT code changes in detail.  

There is still a good deal of confusion around the question: should I opt in or out of Medicare? We know that Medicare Part A and B have virtually no dental benefits included. So, why should a dentist opt in? There are basically two reasons that opting in may make a lot of sense for dentists.

CMS (The Centers for Medicare and Medicaid Services) has made clear that: a dentist that "opts out" of Medicare cannot be paid for supplementary benefits offered by an MA plan (other than emergency or urgently needed services as defined in §422.2).  The Medicare requirement to not pay an opt-out provider at 42 CFR 422.220 applies to all services provided under or through an MA plan.  The definition of "physician" in § 1861(r) includes doctors of dental medicine, so if a dentist has one of the affidavits under § 1802(b), the dentist can't be paid by the MA plan for services covered by the MA plan unless those services are emergency or urgently needed services.  

 

Bottom line, unless you enter into a private contract with the Medicare beneficiary and they agree to pay for your services out of pocket, the dental benefits cannot be paid to you AND you cannot charge the patient for those services. While the decision to opt in or out is yours, you might consider your patient base before deciding to opt out.

Stop by the Delta Dental booth and REGISTER TO WIN A $50 VISA GIFT CARD!

While at the conference stop by and say hi to your Delta Dental Network Development Specialists, Laurie Cassanese-Rhodes and Annette Giles, and let them give you the latest Delta Dental news.

 

Richmond Give Kids A Smile Day, February 5, 2016: DDVA's Richmond office employees volunteered to help keep things moving smoothly.  

"One of the many reasons why I prefer Delta Dental is because of the user friendly website. I can check our patients' eligibility, treatment frequency, and see how much benefit is remaining for the year. Our patients' insurance benefits are easy to read, all with a few clicks. If I have a more complicated issue that requires me to speak to a representative, I know I will be spoken to politely and the issue at hand will be resolved quickly and efficiently. When our patients' frequently ask what dental insurance I prefer, I always, without hesitation, say Delta Dental!"

-Melanie Clark, Patient Advocate, Dr. Faryl K. Hart, Richmond, VA

Delta Dental Member Company Info: Need to contact another Delta Dental member company?

Get a list of all member company addresses, payer id#s, email and toll-free phone numbers.

Benefits and Claims Inquiries: For faster response times, if you have questions about patient benefits or the status of a claim, please contact our Benefit Services department at 800-237-6060 instead of our Provider Relations department. You can also log into our provider website for 24/7 access to patient benefits and claims status reports.