Digital Newsletter Edition
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PACT is live
Be sure to check out Delta Dental's new, improved credentialing portal. The Provider Application and Credentialing Toolkit (PACT) is an online self-service portal that streamlines and simplifies your credentialing needs.
Replacing AppCentral, PACT is Delta Dental’s advanced credentialing platform. It offers a streamlined process, allowing providers to create an account, initiate an application and complete the credentialing process all within the application, a significant improvement over the previous system.
PACT provides a user-friendly interface, ensuring accurate information is recorded. The dashboard allows easy management of applications, with reactive questions and clear instructions that streamline the credentialing workflow for dentists and administrators.
If additional information is needed after submission, providers will receive an email linking them back to PACT, where clear comments and instructions for further edits will be displayed. You can quickly correct an existing application and resubmit to resume the credentialing process with minimal delay.
With PACT’s upload capabilities, users can easily attach files such as certificates, state licenses, or other required documents to supplement the credentialing application.
Agreements can be viewed and signed digitally, with customized agreements for each individual depending on state licensing and network selection. Check out the new PACT here.
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Did you know: Dental Office Toolkit makes attachments easy?
The Dental Office Toolkit® (DOT) makes completing the daily tasks in your practice a breeze. From submitting claims to looking up member benefits to updating office information, DOT saves you time and gets you paid faster. Claims process within seconds, and if you take advantage of the electronic funds transfer option, claims are paid within hours.
DOT also now allows for easy uploading of attachments, making the claims process faster and easier than ever.
DOT is free to use, and if you don’t already have an account, registration is simple. Visit our website to learn how you can set up your DOT profile, find how-to guides and more.
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Important: Delta Dental of Kentucky has a new Provider Portal
Even if your practice is located in a state other than Kentucky, you might have Delta Dental of Kentucky members if they are employees of a business headquartered in Kentucky.
Please note that Delta Dental of Kentucky has updated to a new Dental Portal to verify insurance coverage of Delta Dental of Kentucky patients.
Please use the Dental HUB for all DDKY patient information.
Follow the steps below to verify benefits for patients with coverage from Delta Dental of Kentucky.
1. Go to www.deltadentalky.com.
2. Click “Sign in/Register” in the upper right-hand corner and select the option for employers, dentists and producers.
3. Select the option for "Dental HUB."
4. Click on “Sign in With Delta Dental” and log in through your Delta Dental account.
After signing in, add Delta Dental of Kentucky as a Payer Partner in Billing Set-Up on the HUB utilizing a prior DDKY claim. For further assistance, please email ProviderRelations@deltadentalky.com.
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Three new courses added to the CE lineup
Looking to add continuing education courses to your schedule? Check out Delta Dental’s newest additions to its CE offerings.
Risk management and record-keeping:
This course provides dentists with essential knowledge and skills to effectively manage fraud, waste and abuse risk, along with strategies for ensuring business continuity and maintaining comprehensive record-keeping in their practice. This presentation will demonstrate practical applications and strategies to minimize professional liability while maintaining accurate records for compliance with regulatory requirements. We will also provide dentists with an understanding of fraud, waste and abuse.
Women’s oral health issues:
Women undergo a variety of hormonal and physical changes as they age, including puberty, pregnancy and menopause. These changes may have a significant impact on their overall health, but also their oral health, and the connection between the two is critical. The importance of regular dental visits in young children, establishing a dental home and an effective home care routine that can be maintained long-term are key parts of minimizing the negative effects of hormonal changes in women.
Premedication for invasive dental procedures and prevention of aspiration pneumonia:
The course reviews the current recommendations for SBE and LPJ infection prophylaxis indications and regimens. The history and rationale behind the recommendations will be presented.
Check out the latest course offerings for Michigan.
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Even more CE options
With the goal of helping to improve access to dental care for individuals with disabilities, Penn Dental Medicine has established a FREE new continuing education series through the support of the Delta Dental Foundation. The series, Center for Persons with Disabilities Presentation Series, is aimed at building awareness of the barriers to equitable oral health for individuals with disabilities, and developing competency to provide oral health care to this vulnerable population.
- Live webinars and on-demand courses
- Open to any U.S. licensed dentist and their support personnel at no charge.
- Dentists completing 18 or more of the courses within a three-year period will receive a certificate of completion from Penn Dental Medicine, an ADA CERP Provider, as a Disabilities Dentistry Clinician Expert.
Register for a free course at www.dental.upenn.edu/disabilitiescare.
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New guidelines requiring prior authorization for Michigan Medicaid members receiving service for procedure codes D2710-D2794, D2950, D4341, and D4342 are in effect.
Any claim containing these procedures submitted without a completed prior authorization on or after Oct. 1, 2024, will be denied and not billable to the patient.
Full implementation will begin for these codes is in effect now.
Utilize the Dental Office Toolkit to download and review provider manuals and applicable policies and procedures.
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Keep these in mind:
Recredentialing process
Delta Dental recredentials network dentists every three years as part of your Delta Dental participation agreement. This process is done through the Provider Application & Credentialing Toolkit (PACT), an electronic enrollment and credentialing tool that allows you to complete required documentation, receive real-time application status updates and view archived submissions. Visit PACT here.
Appointment scheduling
If you are scheduling patients who have Healthy Kids Dental, Healthy Michigan Plan or MI Health Link benefits, remember that they must be seen or scheduled within a set time frame. These benchmarks are based on treatment urgency and are required by the Michigan Department of Health and Human Services. Find these benchmarks in your participation contract or below for general practitioners or pediatric dentists:
- Urgent care—see within 48 hours
- Routine services—schedule within 21 business days
- Preventive services—schedule within six weeks
- Initial appointment—schedule within eight weeks
- Emergency services—provider must be available immediately, 24/7
Non-covered service procedure for Medicaid and Medicare members
If a Delta Dental Medicare Advantage or Medicaid member requires services not covered in their benefit plan, be sure to obtain a signed private pay form from that member or member’s guardian before rendering services.
These members may be part of Healthy Michigan Plan, Healthy Kids Dental, Medicare Advantage or MI Health Link program. If a procedure is not listed in Delta Dental’s fee schedule for the above programs, or if it exceeds an age or frequency limitation, it is not a covered benefit under that program and is considered a non-covered service.
Payment for non-covered services is the responsibility of the member or the responsible party. Before providing non-covered services, the cost of the non-covered service(s) must be discussed with the member or responsible party. Treatment can only be provided if and when the member or member’s guardian signs a private pay form (to be signed on the day non-covered services are rendered), where they agree in writing to pay for the non-covered (or alternate) service(s).
You may use any form for the private pay form as long as it includes the cost associated with the non-covered service(s), the responsible party’s signature and the date. (See Delta Dental’s sample form here). Keep the signed form in your files as Delta Dental may request a copy.
The Delta Dental member’s or responsible party’s approval to proceed with non-covered services via the private pay form should be included in the patient’s record. If a member agrees to pay for a non-covered service, Delta Dental dentists will be held to the lesser of the submitted fee or the applicable Delta Dental fee schedule for any charges to the patient or responsible party.
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