Articles
Surgeon General Releases Significant Findings on Oral Health
Attention Internet Users!
Delta Dental Grew 20% in 1999, Says Annual Report
New Web Feature: Online Directions to Dental Offices
Need Claim Forms?
1999 Cost Containment Report
Customer Service Hours Expanded

Surgeon General Releases Significant Findings on Oral Health

Oral health matters. That conclusion is drawn in a report released recently by U.S. Surgeon General Dr. David Satcher and endorsed by the nation's largest affiliation of dental plans, the Delta Dental Plans Association, of which Delta Dental Plan of New Jersey is a member.

The much-anticipated report marks the first time that the U.S. Surgeon General has dedicated this level of attention to oral health issues, and includes a number of significant findings and recommendations.

"Everyone concerned with the state of oral health in America has anticipated this report since it was commissioned in 1997," said Walter VanBrunt, President and CEO of Delta Dental Plan of New Jersey. "As a dental benefits provider, our organization fully supports the Surgeon General's decision to focus on this important issue."

The report states that, "Oral health is essential to the general health and well-being of all Americans and can be achieved by all Americans. However, not all Americans are achieving the same degree of oral health."

Report findings indicate that Americans have experienced significant improvements in oral health over the past few decades. Contributing factors to these improvements include the widespread fluoridation of municipal water, improved dental treatment options, a strong emphasis on preventive dental care and the emergence of dental benefits as a common and valued workplace benefit.

However, not all populations have realized these improvements in oral health. The Surgeon General says there is a "profound disparity" in oral health among population groups, and states that dental and oral diseases affecting certain populations amount to a "silent epidemic."

"Access to care makes a tremendous difference in oral health status, and the Surgeon General's Report acknowledges that availability of insurance increases access to care," said Dr. Scott Navarro, vice president, Professional Services and Dental Director, Delta Dental Plan of New Jersey. "People with dental insurance visit dentists one and a half times as often as people without coverage. This often means healthier mouths, healthier people and cost-effective treatments for problems before they require more expensive procedures."

Just why is oral health so important? The report references a number of recent studies establishing strong connections between oral health and overall health. Dental health affects some of the body's most essential functions, including speech, chewing and swallowing. Other studies have demonstrated relationships between periodontal diseases and systemic illnesses, such as cardiovascular disease, diabetes and pregnancy complications.

"The Surgeon General's Report on Oral Health provides important reminders that oral health means more than sound teeth," said Health and Human Services Secretary Donna E. Shalala, who commissioned the report. "Oral health is integral to overall health. Furthermore, safe and effective disease-prevention measures exist that everyone can adopt to improve oral health and prevent disease."

The Surgeon General's Report outlines a number of suggested actions, including strengthening oral health literacy among policymakers and the public, increasing public/private partnerships to address oral health disparities, expanding initiatives for health promotion and disease prevention and accelerating the building of the nation's science and evidence base on oral health issues.

Dental benefits providers such as Delta Dental Plan of New Jersey can play a key role in implementing many of the Surgeon General's recommendations. Delta Dental supports organizations such as the Dover Free Clinic and Kimball Dental Clinic, which provide dental care to those in need.

Another area where Delta Dental plays an active role is in public and professional education. Delta Dental sponsors numerous programs, including:

• Captain Supertooth, the superhero of dental hygiene, who visits New Jersey schools to spread the word to students about the importance of good oral hygiene.
• The Bloomfield Health Careers Foundation, which trains dental assistants and dental hygienists.
• The Pollack Memorial Scholarship Fund, which provides graduate dental students scholarships for studies at the University of Medicine and Dentistry of New Jersey (UMDNJ).
• UMDNJ continuing education for dental students.

Shalala noted, "To ignore oral health problems can lead to needless pain and suffering, complications that can devastate well-being, and financial and social costs that significantly diminish quality of life and burden American society. Together we can effect the changes we need to maintain and improve oral health for all Americans and remove known barriers that stand between people and oral health services."

Attention Internet Users!

If you use the Internet to correspond with our Customer Service Department regarding a claim or benefit inquiry, please be sure to include:

• The subscriber's Social Security number
• Group number of the subscriber's employer
• Claim number (if any); and
• Your question or concern.

This will help expedite your inquiry and avoid unnecessary delays. Our Customer Service Department can be reached at service@deltadentalnj.com

Delta Dental Grew 20% in 1999, Says Annual Report

Delta Dental Plan of New Jersey achieved its biggest growth increase ever in 1999. New sales topped $31 million, our total business increased to almost $300 million, and we added more than 240 new groups in 1999.

These were just some of the achievements highlighted in our recently published 1999 Annual Report.

Other accomplishments include:

• Meeting all of our Y2K compliance goals.
• Introducing an improved billing system that provides customers with an itemized and easily interpreted statement.
• Replacing mainframe hardware and rebuilding our Image system to make service faster and more efficient.
• Upgrading technology platforms, which will enable Delta Dental to soon put in place a comprehensive Customer Service/Internet strategy.
• Maintaining a customer-retention rate of 95 percent-a rate we have consistently maintained for the past 12 years.
• Processing more than 2 million claims-16% more than in 1998.
• Answering more than a half million calls in Customer Service-and answering 75% of all inquiries effectively and accurately in under one minute.
• Providing one of the nation's most extensive dental-provider networks, with three out of four dentists nationwide participating.

To request a copy of the 1999 Annual Report, send an e-mail to administration@deltadentalnj.com or call Kelly White at (973) 285-4020.

New Web Feature: Online Directions to Dental Offices

Patients in search of a participating dentist near them can throw away their maps and instead log onto Delta Dental's website.

The website not only helps patients identify participating dentists who practice near their home or workplace, but can now tell them how to get there. The site now offers free instant maps and customized directions to participating dental offices.

To check out this service, go to www.deltadentalnj.com and follow the prompts. Please note that maps and directions are accessible only if you indicate in Step 3 that you want to search the directory to find a convenient dentist. The map and direction option is not available if you indicate you want to look up a particular dentist.

Need Claim Forms?

Did you know that you can e-mail us your request to have a supply of claim forms mailed to you? You can also download a copy of the claim form from your computer. To e-mail a request or download forms, visit our website at www.deltadentalnj.com.

1999 Cost Containment Report

Delta Dental is proud to retain its role as New Jersey's leading and largest dental benefits carrier, providing coverage to more than 1.3 million people through contracts with employers in New Jersey and Connecticut.

Last year alone, Delta Dental achieved a 20 percent growth rate increase-our best ever. In 1999, our new sales topped $31 million, and our total business increased to almost $300 million. These results were achieved along with some important technological enhancements.

In addition to meeting all of our Y2K compliance goals, we significantly improved our service levels with a new billing system; mainframe hardware replacement; and the rebuilding of our Image system-all of which are making service faster and more efficient. In 1999, we were able to save our existing clients and/or subscribers $123.8 million and paid more than $250 million in benefits.

Throughout New Jersey and Connecticut, more than 240 new groups came to call Delta Dental their dental benefits service provider of choice, strengthening our leadership position.

Please refer to the Distribution of Savings chart for a complete list of 1999 savings.

For more information on how we can contain benefit expenses for your group, please call a Delta Dental Account Executive at 800-624-2633.

Explanation of Terms

1. Filed Fees/UCR Concept-Reduction of billed charges to reflect the participating dentist's filed fee with Delta Dental, the maximum UCR allowance or maximum allowable charge under a PPO program. Represents savings from utilization of network dentists. Also includes savings when a PPO dentist was utilized.
2. Contractual Limitations-Procedures denied due to generally accepted dental practice or specific contract limitations such as performance of a procedure in excess of the accepted standards of frequency. Also includes reduction to payments due to Table of Allowance, use of prevailing fee limit for non-par dentists and PPO tables (when non-PPO dentists are utilized).
3. Eligibility Verification-Benefit denials for procedures rendered during a period of patient ineligibility under the plan.
4. Non-Covered Services-Benefit denials for procedures excluded from coverage under the group program.
5. Dentist Consultant Review-Procedures which are not supported by diagnostic records or within generally accepted standards of dental care based on direct review or payment policy established by Delta Dental's dental consultant. This includes procedures for which Delta Dental will provide a benefit allowance for an alternative procedure that is within the generally accepted standard of care given the diagnosis or treatment plan.
6. Optional Services-Benefit denials or alternate benefit allowances for dental procedures that are considered optional and may be performed at the expense of the patient.
7. Non-Billable Services-Procedures that are not chargeable to Delta Dental or billable to the patient. Such charges may include component costs of a more comprehensive procedure which therefore do not warrant a separate charge, and services denied as duplicate submissions.
8. COB Savings-Claim dollars saved through the application of coordination of benefit policies in accordance with the group contract, including non-duplication COB reductions where applicable and an enforcement of standard order of benefit determination rules.
9. Total Savings-Sum of savings excluding claims denied for deductibles, copayments, and plan maximums. In some instances, savings may include services which, if allowed, would have exceeded plan maximums.

Customer Service Hours Expanded

As part of our ongoing commitment to service, Delta Dental's Customer Service Department will begin staying open two hours later Monday through Thursday, starting July 5. Customer service will be available to take calls from 8 a.m. to 7 p.m. Monday through Thursday, and from 8 a.m. to 5 p.m. on Friday. The best times to call are usually between 8 a.m. and 9 a.m. daily, and all day Wednesday and Friday.

In addition, our Voice Response System is available 24 hours a day, seven days a week, to order forms and provide information concerning eligibility, benefits, and claims paid status, as well as maximum and deductible balances.

To contact both the Customer Service Department and the Voice Response System, call (800) 452-9310 and follow the prompts. As always, during business hours you can press the star key to speak with a representative.