Delta Dental of Colorado will be completing a system upgrade that will enhance the service experience for our members, providers, employers, and brokers targeted for late first quarter 2021. We are always looking to improve the experience we provide, and we believe this new system is an important part of reaching that goal.
We'll keep you informed on any changes that will affect our daily business interactions as we work toward the completion of this upgrade. More detailed information will be provided in the coming months as we work through all the particulars that are relevant to our provider network.
We are also creating a robust, easy-to-access resource library with everything you will need to know. Important information and updates will be posted on our website and on the secure provider portal, so if you do not have a secure provider account yet, go to deltadentalco.com and create one today. If you have any questions, please contact provider relations at profservices677@ddpco.com or 303-889-8677.
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Reminder on Medicare Advantage Pre-Determination Requirements |
We'd like to remind you about a requirement that took effect September 1, 2020. In order to comply with federal regulations, Delta Dental of Colorado now requires a pre-determination of benefits be submitted for all Basic and Major dental services for Medicare Advantage members. The Center for Medicare & Medicaid Services (CMS), which regulates Medicare Advantage programs, requires that Medicare patients be notified when a procedure is not covered prior to when the service or item is delivered.
This requirement is meant to protect the member, so that they can make fully informed decisions about whether to proceed with the recommended service.
You will need to submit the request directly to DDCO as an undated claim, like any other pre-determination, not just a faxback. DDCO will have 14 calendar days to respond to the request for non-urgent pre-service requests and 72 hours for urgent pre-service requests.
If the request is denied in part or in whole, providers will receive an Integrated Denial Notice (IDN) via email or fax and mail for the member. If a patient submitted their own claim, the IDN will only be mailed to them. Providers will also be able to view approval or denial via pre-determination vouchers. Pre-determination benefit vouchers can be found via the provider portal or mailed to your office.
If you have any questions, please contact provider relations at 303-889-8677 or profservices677@ddpco.com.
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Provider Directory Update |
We are currently working on updating our provider directory with the most accurate, up-to-date information, and we need your help. Please download, print, and complete the linked form by clicking here by September 30, 2020.
You will need to list the billing tax ID number (TIN) and names of the providers that are currently practicing at this location. There is no need to complete the form if you recently completed it and there are no changes such as new providers, retired providers, or providers that are no longer at your location.
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PPE Reimbursement Program |
In order to facilitate the safe reopening of dental practices in compliance with COVID-19 protocols, DDCO offered a personal protective equipment (PPE) Reimbursement Program for our Delta Dental PPO™ and Premier® network providers in Colorado who signed up for direct deposit. This temporary program was in effect for May, June, and July 2020 and was designed to help our network providers adjust to the added cost of PPE.
The program achieved the following results:
- DDCO paid more than 1,400 unique providers/DSOs, approximately $2.4 million from May to July.
- On average, a provider/DSO received $1,700 during the program or $590/month
- The median payment amount was approximately $1,240 for the program or $405/month.
Thank you for continuing to provide the best service possible to our members, your patients, during these uncertain times.
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On October 12, 2020, Delta Dental of Colorado will be moving the location of our headquarters. Our new address will be:
6465 Greenwood Plaza Blvd., Suite 900
Centennial, CO 80111
If you currently use paper claims, you may continue to submit them to PO Box 173803, Denver, CO 80217-3803. Appeals can also continue to be submitted to PO Box 172528, Denver, CO 80217-2528.
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CDC Division of Oral Health seeks applicants for Dental Public Health Residency Program
Ada.org, September 10, 2020
The Centers for Disease Control and Prevention’s Division of Oral Health is now accepting applications for the 2021–2022 Dental Public Health Residency Program.
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