Financial Solutions for your Dental Practice
NJ Dentists: Peapack-Gladstone Bank and Delta Dental of New Jersey are offering below-market loan rates to NJ dentists. Click here to learn more.
Documentation Requirements Change for D7960
For patients less than two years of age on the date of service, required documentation for D7960 will be a narrative and optional photos. This documentation requirement goes into effect March 1, 2016. For a list of other procedures requiring documentation, see the documentation requirements table in Chapter Four of the Participating Dentist Handbook.
Searching For New Patients? Go PPO!
Delta Dental of New Jersey is pleased to announce participating oral surgeons, periodontists, endodontists, orthodontists, and prosthodontists in New Jersey and Connecticut are invited to join the Delta Dental PPO℠ network. With 48.7 million Delta Dental PPO members nationally, we believe that joining the Delta Dental PPO network is a way to bring new patients into your practice. Please contact your Dental Network Coordinator at 888-396-6641 or via email at email@example.com to join today.
‘100% Par’ Is Now Our Standard – Is Your Practice Compliant?
Effective 10/2015, we now require all dentists who render any treatment in "participating practices" to sign a Participating Dentist Agreement with us. To verify that your practice is in compliance, log in to Benefits Connection and click “My Participation.” Non-participating dentists must contact their Dental Network coordinator at 888-396-6641, or firstname.lastname@example.org to apply to become participating dentists.
Mandatory Pre-Authorization Charts for EHB Members
Click here, and scroll down to “Claims.”
Sending a Claim Electronically that Requires X-rays
Sending a claim electronically that requires X-rays and also sending the paper claim with the diagnostics is not necessary. We process the electronic claim faster and send an info-request for the diagnostics that are required. When both an electronic and a paper claim is sent, often, the paper claim is denied as a "duplicate," and many times the x-rays are not reviewed.
Reminder Regarding Diagnostic Requirements
Delta Dental’s Diagnostic and COB primary carrier statement requirements can be found here.
Participating Dentist Handbook
The Delta Dental Participating Dentist Handbook is available in Benefits Connection under “Other Tools” on the right navigation pane.
Important Reminder for Connecticut Orthodontists
If your practice is submitting cases for a HealthyCT patient, you must pre-authorize and submit diagnostics, including the Saltzman scale. If services are not pre-authorized, benefits may be disallowed. For more about which services require prior authorization, as well as the Connecticut Saltzman Handicapping Malocclusion Assessment Record, click here, and scroll down to “Claims.”