Benefits administrator blog from Delta Dental

Tag: dental care (Page 1 of 3)

Stories to smile about: Robert

Dental care with dignity – war veteran gets his smile and his life back.

2-minute read

What if a healthy smile could restore dignity, improve your quality of life and career outlook? For one very deserving man, that’s exactly what happened when he visited one of the UNLV Delta Dental Saturday Morning Community Clinics.

After many years of suffering with teeth that caused physical and emotional pain, Vietnam War veteran Robert Bennett finally received the care his smile needed at the Sgt. Clint Ferrin Memorial Clinic, one of four dental clinics that make up the UNLV Delta Dental Saturday Morning Community Clinics.

This is what Robert had to say to UNLV about his experience at the clinic:

“It’s not only [that I was] happy with the care, it’s the professionalism that goes along with it — it’s the way you’re treated from the time you walk through the door, to the time that you get into the chair. And then the doctors that oversee what [the dental students] do and help, they come up constantly, and they introduce themselves and let you know what you’re going to be going through.

[They] had to surgically remove almost every tooth in my mouth, or what was left of my teeth. [After receiving treatment and a full set of dentures,] I’m eating and smiling and communicating with people again. It changes your life. I mean it just gives you your dignity back. You are somebody again. And I get to apply again for a job. Look what they did!”

Robert Bennett, Vietnam War veteran

Robert’s story is especially meaningful to us at Delta Dental. Last year, The Delta Dental Community Care Foundation granted $50,000 to support these clinics, which provide much needed dental care to underinsured and uninsured people throughout Southern Nevada.

Successes like this are the reason the Foundation exists — to improve health and enhance lives in the communities we serve. We’re so grateful for partners like the UNLV School of Dental Medicine, who give us opportunities like this one to make a real difference.


To ensure you never miss a story like this, subscribe to Word of Mouth, our newsletter for benefits administrators, human resources professionals and businesses.

Do you have a project that qualifies for funding? Visit the Foundation’s section of our website to learn more and apply for funding.

Tackling orthodontics

With football season just around the corner, it seems fitting to tackle a popular, yet often misunderstood topic — orthodontics. If you’re offering your employees orthodontic coverage, make sure you’re up to speed on your dental benefits game.

If you don’t already offer orthodontic benefits, you might consider coverage at renewal, as it can be an attractive benefit if you’re trying to build or retain your workforce. A recent study shows that 88% of employees take “better health, dental and vision insurance” into consideration when choosing a job.

The Xs and Os

Generally, here’s what our plans cover*:

  • Pre-orthodontic treatment visit
  • Pre- and post-treatment records
  • Extractions for orthodontics
  • Orthodontic treatment
  • Retention

The MVP

Our copay orthodontics game is strong! Compared to typical copay products (similar to DHMOs), DeltaCare® USA is leading the league, with features like:

  • A variety of treatment levels — interceptive orthodontics for children, limited orthodontics for children and adults, and comprehensive orthodontics for children and adults*
  • A unique orthodontic takeover provision that allows enrollees to continue active treatment with their current orthodontist — even if the provider is not in our DeltaCare USA network
  • Extractions for orthodontic treatment that could save enrollees hundreds of dollars out-of-pocket

If you currently offer orthodontic coverage, review the playbooks for Delta Dental PPOTM and DeltaCare USA plans and pass them on to your employees. For specifics, you can review your group contract and enrollees should log in to Online Services (or review their plan booklet) to confirm coverage.

 For more news and dental insights for benefits administrators, human resources professionals and businesses, subscribe to Word of Mouth.

Are you a broker, agent or consultant? Subscribe to Insider Update, our newsletter for benefits producers.

 

* Your benefits may differ from the general information provided here. Review your group contract for specific details regarding coverage under your plan.

Benefit tips for enrollees to pack for vacation

2-minute read

With summer vacation season heating up, you may worry about the impact this could have on managing your group’s dental benefits. We’ve got good news — with these packing tips you can also relax knowing that Delta Dental benefits have your enrollees covered.

Travel to the dentist first
Dental emergencies are hard enough when your enrollees are home — dealing with one during vacation can be even more unpleasant. That’s why it’s so important to encourage your enrollees to receive dental checkups regularly.

A minor toothache now might seem like it can wait, but what if it becomes excruciating during a once-in-a-lifetime gondola ride on the Grand Canal? Ouch! Taking care of minor oral health issues before traveling can help decrease the chance of costly problems while enrollees are out of town.

Packing tip:  Encourage enrollees to visit the emergency care section on our SmileWay® website to help them prepare for any dental issues that arise when they’re away from home.

 

Map out providers
If an oral health emergency occurs, your enrollees shouldn’t wait until after vacation to seek treatment. From coast to coast, your Delta Dental PPOTM1 enrollees can visit any licensed dentist to receive care without preauthorization.2 DeltaCare® USA1 enrollees are also covered with an out-of-area emergency benefit.3

Packing tips: Enrollees can visit our website to find a network dentist by location or specialty, and even compare Yelp ratings. And for more information on receiving care away from home, enrollees can check out this helpful guide.


Document experiences abroad
Emergency treatment coverage abroad varies by plan type. Encourage enrollees to check their plan details before vacation, and let them know they will need to file their own claim along with a detailed receipt from the treating dentist with the following information to receive reimbursement:

  • Date of service
  • Dentist name and address
  • List of procedures and affected teeth
  • Currency in which to make payment

Packing tip: Share this article with enrollees to give them more details on receiving dental care while outside the U.S.

 

Want more helpful benefits tips like this? Be sure to subscribe to Word of Mouth, our group newsletter.

If you’re a broker, consultant, or other benefits producer, subscribe to Insider Update.

 

 

 

1Delta Dental PPO is underwritten by Delta Dental Insurance Company in AL, DC, FL, GA, LA, MS, MT, NV and UT and by not-for profit dental service companies in these states: CA – Delta Dental of California; PA, MD – Delta Dental of Pennsylvania; NY – Delta Dental of New York, Inc.; DE – Delta Dental of Delaware, Inc.; WV – Delta Dental of West Virginia, Inc. In Texas, Delta Dental Insurance Company provides a Dental Provider Organization (DPO) plan.

DeltaCare USA is underwritten in these states by these entities: AL — Alpha Dental of Alabama, Inc.; CA — Delta Dental of California; DC, DE, FL, GA, LA, MS, MT, WV — Delta Dental Insurance Company; MD, TX — Alpha Dental Programs, Inc.; NV — Alpha Dental of Nevada, Inc.; UT — Alpha Dental of Utah, Inc.; NY — Delta Dental of New York, Inc.; PA — Delta Dental of Pennsylvania. Delta Dental Insurance Company acts as the DeltaCare USA administrator in all these states. These companies are financially responsible for their own products.

2 Applies to covered services; enrollees should consult their contract before receiving treatment. Enrollees’ out-of-pocket costs are likely to be lower if they receive emergency care from a dentist who is in their network.

3 Authorization for treatment may be required. Enrollees should consult their contract for the specific out-of-area provisions for their plan before receiving treatment.

Making music and smiles: Spotlight on a rockin’ dental consultant

4-minute read

So, your carrier tells you it has dental consultants on staff. You first thought may be “that sounds great!”, but you’re also probably left wondering what that actually means. We think there’s no better way to show you than by introducing you to one of our dental consultants, Dr. Leigh Westee. She also happens to be an incredibly interesting human.

Whether you met Dr. Westee during her days as a practicing dentist or you run into her now as a dental consultant, a couple of things remain the same. She’s still passionate about helping patients receive exceptional dental care, and she still spends her free time playing bass in a hard rock band.

 

How long have you been with Delta Dental? What did you do previously?
It will be seven years this April — and I’ve been a dental consultant the whole time. Before working here, I practiced dentistry for 21 years. While I worked in some large practices, I also did mobile dentistry for a while. I would go into nursing homes and set up right in the beauty salon.  I felt incredibly useful — both in providing care and good company.

It sounds like you really liked practicing. What made you become a dental consultant?
I was just ready for a change, and so were my joints! I taught a bit at some dental hygiene schools and really liked it, so I wanted another position where I could apply all the knowledge I’d gained in the dental chair, but still help patients. This position ended up being the perfect fit.

So what exactly is it that you do?
Mostly I review complex claims for Delta Dental PPOSM — like numerous visits for the same procedure. I compare claims to x-rays and other medical data, then apply the plan’s policies. I always remember there are people on the other end, so it’s also really important we take the enrollee and provider perspectives into account.

I also evaluate claims if a dentist or enrollee sends in a dispute or grievance. This is where you’ve really got to be a detective. For example, a new crown could be denied because it doesn’t meet a plan’s frequency limitations, but there are situations where we might override that. We may allow a new crown if the current crown broke and a different dentist had to provide a new one. That’s when I would look at all the info that went with the dispute, like x-rays and charts, and make an informed decision.

Any advice for groups to take back to their enrollees?
Receive routine preventive care. Going to the dentist every six months can greatly reduce the chances of running into most of the claims issues I’m reviewing. You wouldn’t neglect your oil change for five years, so why do the same with your body? Keep your mouth maintained and you can help avoid expensive visits in the future.

What are the biggest challenges you face in your work?
Making decisions on claims is not something we take lightly, so there are definitely times where I can’t make a decision on my own. That’s when I rely on my colleagues to share their expertise — two other dental consultants who work on PPO claims sit right next to me. There are also separate consultants who work on DeltaCare® USA claims and an orthodontist for ortho claims.

Speaking of expertise: How do you keep your skills sharp?
Even though we’re not practicing, we still have to maintain a dentist license. I take about 20 credits of continuing education courses every year. Plus, the whole team of dental consultants meets every month to learn about new topics and share insights.

Wow, you guys certainly stay busy! How do you relax outside of work?
I play bass in two hard rock bands. I taught myself how to play by ear — I actually can’t read music. I had to practice for hours every day for months until it started to click, and I still have to practice a lot. Dentists do like to keep their hands busy!

The first band I joined was an all-female KISS Tribute Band. Now I’m in a Cheap Trick tribute band called Dream Police and an 80s hard rock cover band called Iron Mullet. We get really into the costumes and makeup too. We’ve been hired out for rock events just to make appearances in costume.

That’s so cool. Have you ever met any of your rock idols?
I made it a goal to meet my five favorite bass players. It took me about 15 years, but I did it, and even had their signatures tattooed on me. Oh, and I met Alice Cooper.

I’m sure those are great stories … you’ll have to share with me some day. One last question. If you could remix one of your favorite songs like the singing dentist, what would it be? Can you give us a line?
I’d go with a KISS song. How about “I want to brush and floss all night”?

Thanks for rockin’ out with Dr. Westee! Stay tuned for our second dental consultant spotlight later this month, which will highlight dental phobias and ways to ease enrollees’ fears. And don’t forget to subscribe to Word of Mouth, our newsletter for benefits decision makers, administrators or HR professionals.

Are you a broker, agent or consultant? Subscribe to our producer newsletter, Insider Update.

New, stronger evidence to support gum disease and heart disease correlation

The dental industry has been aware of the correlation between periodontal disease and a range of overall health issues for years, but there is new, more significant evidence to support the correlation between oral bacteria and heart disease.

A recent study found association between the virulence genes of several bacterial species that cause periodontal disease to atherosclerosis (plaque buildup in the arteries). Virulence genes are what make bacteria effective — in part by allowing bacteria to attach to healthy cells.

For the study, researchers took plaque samples from 65 patients with heart disease from plaque buildup in the arteries and from periodontal pockets, and concluded that the results “strongly correlate periodontal bacterial co-occurrence and periodontal bacterial adhesion factor to atherosclerosis.” This means that the presence of oral bacteria, and the bacteria’s ability to attach to cells, coincides with a higher risk ratio of atherosclerosis.

Previous research studied only the presence of oral bacteria in heart disease patients, but advancements in technology allowed researchers to study the virulence genes of several bacteria species to draw a stronger correlation.

This new evidence does not prove that the oral bacteria is causal, but it does raise more concern for the implications of gum disease — and highlights the importance of monitoring and improving oral health.

Want to learn more about gum disease or other oral health topics? Visit the Oral Health section of deltadentalins.com and encourage your employees to take our gum disease risk quiz.

Orthodontia: The original brackets

In the spirit of March Madness, let’s talk brackets. The dental kind! If you’re offering your employees orthodontic coverage, make sure you’re up to speed on your dental benefits game.

If you don’t already offer orthodontic benefits, you might consider coverage at renewal, as it can be an attractive benefit if you’re trying to build or retain your workforce. A recent study shows that 88% of employees take “better health, dental and vision insurance” into consideration when choosing a job.

The Xs and Os

Generally, here’s what our plans cover*:

  • Pre-orthodontic treatment visit
  • Pre- and post-treatment records
  • Extractions for orthodontics
  • Orthodontic treatment
  • Retention

The MVP

Our copay orthodontics game is strong! Compared to typical DHMO-type products, DeltaCare® USA is leading the league, with features like:

  • A variety of treatment levels — interceptive orthodontics for children, limited orthodontics for children and adults, and comprehensive orthodontics for children and adults*
  • A unique orthodontic takeover provision that allows enrollees to continue active treatment with their current orthodontist — even if the provider is not in our DeltaCare USA network
  • Extractions for orthodontic treatment that could save enrollees hundreds of dollars out-of-pocket

If you currently offer orthodontic coverage, review the playbooks for Delta Dental PPOSM and DeltaCare USA plans and pass them on to your employees. For specifics, you can review your group contract and enrollees should log in to Online Services (or review their plan booklet) to confirm coverage.

 

* Your benefits may differ from the general information provided here. Review your group contract for specific details regarding coverage under your plan.

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