New and improved credentialing portal is coming
Test here. Network dentists have asked for an improved credentialing experience, and we’re excited to announce that upgraded experience is on its way.
Delta Dental of Michigan, Ohio, and Indiana’s new online self-service portal for provider credentialing, The Provider Application & Credentialing Toolkit (PACT) is set to release this summer.
PACT will replace AppCentral as Delta Dental’s new credentialing platform and will allow providers to create an account, initiate an application, and complete the credentialing process all within PACT’s online portal.
Improved Credentialing Experience
PACT offers a seamless self-service credentialing experience for providers. Providers can easily manage applications within the PACT dashboard with an intuitive user interface that ensures accurate information is being recorded. Reactive questions and clear instructions streamline the credentialing workflow for dentists and administrators alike.
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. A provider’s existing application can be easily corrected and resubmitted to seamlessly resume the credentialing process.
With PACT’s upload capabilities, users will be able to 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.
Get started with PACT
All of these improvements will contribute to a streamlined credentialing experience for providers and administrators alike. Stay tuned for more updates regarding PACT and Delta Dental’s new credentialing experience.
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Do you know your Delta Dental rep?
Delta Dental of Michigan has a team of professionals dedicated specifically to servicing the needs of our network providers. Do you know who your representative is?
Michigan map
Check out the map for your state to find out and feel free to reach out any time you have questions, comments or concerns. We’re here to help!
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Reminder: Prior authorization required for certain Medicaid codes
Beginning October 1, 2024, prior authorization for Michigan Medicaid members will be required for the following procedures codes: D2710-D2794, D2950, D4341, and D4342. Any claim containing these procedures, submitted without prior authorization on or after October 1, 2024, will be denied and not billable to the patient. A preliminary launch of this process began on May 1, 2024.
Please submit prior authorization for these codes in preparation for the full implementation in the fall.
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Michigan rolling out kindergarten oral health assessment program
Delta Dental’s efforts to push through Public Act 316 of 2023, which requires all Michigan kids entering kindergarten beginning in the 2024-2025 school year to have an oral health assessment before starting school, were a success and the program is rolling out now.
The Delta Dental Foundation provided $1.5 million in funding to help with the program, and the State of Michigan devised the Kindergarten Oral Health Assessment Program (KOHA) to improve school readiness and raise awareness of the new requirement.
It’s important to note that the program, while required to begin this fall, will roll out over three years. MDHHS is working with county health departments on participation. To see if your county is participating, refer to the MDHHS map on this page.
Under the law, any dentist, registered dental hygienist (RDH), or dental therapist licensed in Michigan can conduct the assessments. The assessments may be done through the LHD or within a private dental office.
How can providers help?
The most obvious way to participate in the KOHA program is to offer assessments in your office. The State has created a website with resources to help with this effort.
Some of the key information you should know includes:
- Parents may request your office perform a KOHA assessment. The majority of KOHA dental assessments will likely be done by local health departments, similar to the State’s hearing and vision screening programs. However, parents may request that the assessment be done by your office instead.
- The assessment will not alter your usual office protocols for new or existing patients. The only additional part of the visit is the completion of the required KOHA Assessment Form.
- Either a dental examination or a dental assessment will meet KOHA requirements. The service should be done within six months prior to the start of kindergarten. Either a dentist or registered dental hygienist can provide the service within their scope of practice.
- Results should be documented on the KOHA Assessment Form. The completed form should be returned to the school by the parent or guardian.
To download a copy of the form and updated information on the program, be sure to visit the Department of Health and Human Services’ KOHA page for dental providers.
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Are you using the Dental Office Toolkit?
Purpose-built to streamline administrative tasks, enhance communication and improve overall efficiency within your practice, Delta Dental’s Dental Office Toolkit (DOT) can make your office more efficient. This free system offers a ton of features, including:
- Online claims submissions
- Real-time claim status udpates
- Patient coverage eligibility verification
- Electronic Funds Transfer option
- Pre-treatment Estimates
- Training resources
If your office isn’t currently using the Dental Office Toolkit, we’d love for you to test it out. You can get started at dentalofficetoolkit.com. For more detail on the system and its features, check out this flyer.
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Did you know Delta Dental offers free CE credits?
Continuing Education credits are a requirement for licensure and Delta Dental wants to make your CE efforts painless by offering free online courses through our Provider Learning portal.
Any dentist, hygienist, dental assistant or office staff member who is a Delta Dental participating provider or works for a Delta Dental participating provider may take these courses.
These courses are available 24/7 to help you conveniently and cost-effectively comply with ongoing regulatory demands so you can get quickly get back to what you would rather do—serve patients.
Courses include an informational video on each topic and an assessment. Complete them at your own pace. Upon completion, you will receive a certificate.
Check out the latest course offerings for Michigan.
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Avoid these common mistakes when submitting claims
We try to make the claims submission process as quick and hassle-free as possible. We take pride in the fact that we process most claims submitted through our Dental Office Toolkit in a matter of seconds and, if enrolled in voluntary the Electronic Funds Transfer system, those claims are paid within 24 hours.
But, sometimes, claims are rejected simply because of an error when submitting the claim. Here are a few common errors to avoid that can lead to delays in processing claims.
- Make sure all info is contained within the box provided.
- Use all CAPS, if possible
- Do not attach a primary voucher with a claim
- Do not enter $0 unless the primary carrier’s determination was actually $0
- When submitting for services previously approved on a pretreatment estimate, use the pretreatment form and fill in the date service was completed. Do NOT send a new claim.
- Always submit claims using your own fee schedule and not the amount on Delta Dental’s fee schedule.
- Always submit a claim with the treating dentist’s name and license number regardless of the business name or business owner. The claim form is a legal document and the treating dentist’s information must represent who treated the patient.
- For procedure codes that require multiple appointments, always submit using the date the treatment was completed. For example, if submitting for a crown, always use the seat date and not the prep date.
- Do not highlight any section of the claim form as this will black out the highlighted areas.
New training is paying off for dental offices
If you’ve called Delta Dental of Michigan, Ohio, or Indiana’s customer service lately, odds are you were updated on our self-service tools, which are simplifying and making things more efficient for dental offices. Thanks to a new annual training program, Delta Dental customer service representatives are more prepared than ever to empower and educate providers on the benefits and features of Delta Dental’s self-service tools.
The training seems to have had a significant impact, with more than 30 providers calling to express their appreciation for Delta Dental agents’ guidance and assistance in using self-service tools such as the Dental Office Toolkit (DOT) and the Dental Automated Service Inquiry (DASI) systems.
Both of these systems can significantly impact your business’s ability to submit claims quickly and correctly. If you need assistance using these tools, you can reach customer service at 800-524-0149.
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