Policy for provider calls to customer service
As the COVID-19 pandemic spread nationwide, the Delta Dental of Michigan, Ohio, and Indiana customer service team began answering member phone calls exclusively and asked that providers use the Dental Office Toolkit® (DOT).
On April 27, 2020, we will begin accepting calls from providers who need assistance only with claims questions, problems and adjustments.
If you have questions about eligibility or benefits, you should continue to use DOT. Customer service representatives will not provide this information over the phone for any plan except Medicare Advantage and Medicaid plans. General information will still be accessible through DASI.
This is a long-term policy change. With fewer eligibility and benefit calls, our representatives can focus more on complex issues for both providers and members.
This change empowers you to access information exactly when you need it. No more time spent on the phone or waiting in a call queue. Plus, DOT’s new features give you easy access to:
- Check patient eligibility and review patient benefits.
- Submit claims and pre-treatment estimates in less than 60 seconds. Most are processed in real time, so you’ll see an Explanation of Benefits with the anticipated payment and copayment amounts.
- Post payments and update EFT information.
- Search comprehensive family claims history across all businesses.
- Manage user roles and permissions for your office staff.
What if I don’t have computer access? General eligibility or benefit information will still be available through DASI. However, any additional information must be accessed through DOT. Customer service will only assist with claims questions, problems or adjustments.
How do I register for a DOT account?Visit www.dentalofficetoolkit.com to register your office. Training videos, how-to guides and other resources are available to help set your office up for success.
I need help registering my office for DOT or have questions. Who can I call? Our Toolkit support team is available to get you started and answer any questions you have. Call them at 866-356-0301.
What if I can’t find the answer I need on DOT? Benefit or eligibility information for nonroutine codes not found in DOT can be obtained by submitting a pre-treatment estimate.
Does your patient have Delta Dental coverage through a Medicare Advantage or Medicaid plan? Be sure to call the appropriate number to reach the correct service center.
Michigan, Ohio or Indiana Medicare Advantage: 800-330-2732
Healthy Michigan Plan and Pregnant Women Dental: 866-558-0280
Healthy Kids Dental: 866-696-7441
MI Health Link: 800-838-8957
Delta Dental now paying code D2941
Delta Dental prioritizes the health and safety of our providers and members as we navigate through the COVID-19 pandemic.
We have made an interim policy change regarding code D2941 due to findings by the World Health Organization and the Centers for Disease Control and Prevention (CDC) that show primary transmission of the coronavirus through upper respiratory tract droplets.
The American Dental Association and the CDC recommend avoiding aerosols when possible, like those generated from high-speed rotary instruments commonly used to prepare teeth for permanent restorations.
To support this precaution, Delta Dental of Michigan, Ohio, and Indiana is now paying D2941—Interim therapeutic restoration: primary dentition—Placement of an adhesive restorative material following caries debridement by hand or other method for the management of early childhood caries.
Before this interim change, D2941 would not have been billable if a permanent restoration is completed within 24 months.
Once the COVID-19 pandemic subsides, a definitive restoration can then be placed without financial penalty to the dentist or patient.
For permanent teeth, continue to use code D2940—Sedative fillings, temporary restorations used to relieve pain during an interim period—with the same rationale for treatment.
Suspension of paper claims processing
Delta Dental of Michigan, Ohio, and Indiana previously advised you that paper claim processing would experience significant delays due to procedures enacted to protect our employees. As of April 7, 2020, a decision was made to suspend processing of all paper claims, as we felt it was necessary to protect the health and safety of our employees. Electronic claims will continue to be processed as usual.
Paper claims are processed in our Oakland County, Michigan office. Oakland County, together with surrounding counties of Wayne and Macomb, have been identified as COVID-19 hot spots. We did not want to place our employees at a heightened risk and opted to close the facility until the Oakland County area experiences a decline in cases. While we recognize the impact to our providers, a cost-free alternative to submitting paper claims is available to you.
We encourage you to submit claims through the Dental Office Toolkit® (DOT). If you do not already have a DOT account, you can create your free account here. DOT is an online portal that provides you with 24/7 access to instant claims processing, patient eligibility and benefit information and much more. You can also enroll in EFT payments—view the tutorial here.
April 2, 2020: COVID-19 updates from Delta Dental
Delta Dental of Michigan, Ohio, and Indiana wants you to be armed with all the resources available to you during the rapidly evolving COVID-19 outbreak. We are constantly assessing ways to support our providers, and we will be in touch with any new developments.
- You may have heard that the Delta Dental Foundation, the philanthropic arm of Delta Dental of Michigan, Ohio, and Indiana, established the $500,000 COVID-19 Emergency Assistance Fund. The fund will address needs faced by both safety-net dental clinics and nonprofits in Michigan, Ohio and Indiana who work with vulnerable populations and provide health services or food assistance.
- MICHIGAN: For resources and information for your practice including details on the Michigan Small Business Relief Program, visit michiganbusiness.org/covid19 or call the Michigan Economic Development Corporation at 888-522-0103. The U.S. Small Business Administration also offer details on small business guidance and loan resources.
- OHIO: Given the critical need in Ohio hospitals for personal protection equipment (PPE), if it is possible for your practice to review its inventory and identify items to donate locally, please consider doing so. Contact the state of Ohio to let them know what you can provide by emailing firstname.lastname@example.org. More information is also available here. We are making this request in conjunction with the recommendations by the Ohio Chamber of Commerce.
- Don’t forget to check out The American Dental Association’s website, ADA.org/virusresources, that offers practice management resources, including a Q&A document about the Small Business Interruption Loans under the federal CARES Act and information about the ADA Foundation Charitable Assistance Fund grant program. The ADA also offers webinars about topics including the CARES Act, infection control and business impact of the pandemic. Scroll to the bottom of this site for information.
- If you’re aware of any unsung heroes doing great work in your community, please pass along the story and contact information to Lisa Nguyen at email@example.com.
Thank you for everything you’ve done and continue to do to be part of the solution to this unprecedented public health crisis.
Virtual Evaluation interim policy during COVID-19 pandemic
The health and safety of our providers, members and employees is Delta Dental’s top priority as we attempt to navigate the disruptions related to COVID-19.
Based on the recommendations of some of the governors and state dental associations in the states in which we do business, many dental offices are restricting service to urgent or emergency cases only.
Delta Dental understands some offices have the capability to perform evaluations via audio or video technology. Please be mindful of patient privacy when using this technology. Also, know that the Office of Civil Rights (OCR) at the Department of Health and Human Services (HHS) says it, “will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency.”
Unless there is a specific exclusion, Delta Dental of Michigan, Ohio, and Indiana plans will benefit D0140 (Problem Focused Examination) per group contract whether provided in a dental office or virtually, effective from March 20, 2020, until the public health situation is resolved.
The service will be paid providing the patient has coverage/benefits available.
We will continue to evaluate these interim policies as necessary. Thank you for the care you provide to our members, especially during these most challenging times.
Be safe through the coronavirus outbreak
At Delta Dental, we prioritize health and safety.
The worldwide coronavirus outbreak has us all concerned and taking extra precautions, even as the news and numbers change by the hour.
As you continue your vigilance to keep your patients and staff safe, here are some reminders from our chief science officer, Jeffery Johnston DDS, MS:
- Some states that have had rapid spread of infection have recommended taking the temperature of patients prior to being seen, since elevated temperature is an early sign of the COVID-19 infection.
- Aerosols should be minimized by use of rubber dams or dental isolation systems such as Isodry devices.
- To prevent infection, universal precautions are recommended, such as frequent hand washing for 20 seconds and the use of a hand sanitizer that contains 60 to 95 percent alcohol.
- Patients who show signs of the infection should be rescheduled. Elective and nonemergency procedures should be postponed.
You may have already experienced the shortage of personal protection equipment, particularly masks. We haven’t heard when supplies will return to normal.
At Delta Dental, we have put travel restrictions into place for our staff, and we’re working with our risk management team to minimize the threat to our business functions. Claims continue to be processed as normal.
If the virus continues to spread, our customer service centers may be affected, and we recommend that providers use our Dental Office Toolkit® to submit claims and to obtain eligibility and benefit information for your patients.
For the most updated information:
Procedure change—claim submission
To reduce the risk of exposure and to ensure the safety of our employees, Delta Dental will close its office buildings Thursday, March 19, through at least Wednesday, April 1. This does not mean our work will stop. Employees will continue to work remotely, and with our robust Roosevelt claims system, claims submitted through our Dental Office Toolkit® (DOT) will be processed as usual.
As part of this response, Delta Dental will hold processing on all paper claims until our office reopens. All providers should instead submit claims through DOT.
- There are several tutorials on our website regarding DOT, including one that provides step-by-step instructions on submitting a claim. View the tutorials here.
- If you do not already have a DOT account, you can set up your free account here.
Our customer service team will not be available to take provider calls during this closure. You should plan to utilize DOT for patient benefits and eligibility, pretreatment estimates and more.
If you need direct assistance with DOT, contact Toolkit support at 866-356-0301.
Regarding the spread of the coronavirus, we encourage you to access the following resources:
We appreciate your understanding during this difficult time.
Michigan providers: Help hospitals with the PPE shortage
Given the critical need in Michigan hospitals for personal protection equipment (PPE), if it is possible for your practice to review its inventory and identify items to donate locally, please consider doing so.
Equipment can be shipped or dropped off at the closest Regional Emergency Management Coalition site.
Delta Dental of Michigan is making this request in conjunction with the recommendations by the Michigan Health and Hospital Association and the Michigan Dental Association.