Decem ber  2018

Updated 2019 Fees Include an Increase to Crowns and Bridges 
The 2019 Delta Dental of Colorado fee schedules have been updated and are available. Thanks to the continuous feedback you've provided, and as part of the updated schedules, crowns and bridges will receive a fee increase effective January 1, 2019. The crowns and bridges fee will vary by CDT code.  

You can view updated fee schedules by visiting our  websiteClick on the PROVIDER Login, log into your account, click on the Documents tab for PPO and MPA fees, and search for codes through the Web Procedure Code Search. 
Change to D8999 Processing Policy 
The Delta Dental Plans Association (DDPA) processing policy for code D8999 (orthodontics) will be modified effective January 1, 2019. The benefit will be based on the approved fee for conventional orthodontics such as Invisalign and Incognito. Any additional fee up to the submitted amount for the non-traditional method will be disallowed and not chargeable to the patient.

2019 Updated Codes Available Online
Effective January 1, 2019, the American Dental Association (ADA) has added 15 new codes and deleted four codes in the Code on Dental Procedures and Nomenclature (CDT). Here are the changes:


Please make note of these additions and deletions to ensure timely processing of claims. Not all of these codes are covered services, depending on the patient's plan. Please use the website, click on the PROVIDER Login, log into your account, to search for codes through the Web Procedure Code Search. You can also see any relevant codes as benefits on a patient's plan. 
Medicare Opt-Out Reminder
Dentists no longer need to opt in (enroll) or opt out of Medicare to continue to provide dental care, supplemental services, and prescriptions for patients on Medicare or Medicare Advantage plans. The federal Centers for Medicare and Medicaid Services (CMS) had issued a rule in 2014 that required dentists and other health care providers to either opt in or opt out of participation in Medicare. As of November 2017, Medicare announced the permanent cancellation of the opt-in and opt-out requirements for dentists. 

In making these policy revisions,  CMS hasn't rescinded the two-year opt-out period for providers. Dentists who've already opted out of Medicare can't bill a Medicare or Medicare Advantage plan until their two-year opt-out window expires, but they can continue to use private contracts with patients to provide care until the two-year restriction expires. Dentists currently under a Medicare opt-out contract can call Colorado's Medicare vendor,  Novitas, at 855-252-8782 to ensure their opt-out doesn't automatically renew at the end of the current two-year window.

If you signed an opt-out affidavit on or after June 16, 2015, the opt-out will automatically renew every two years. Dentists who filed a valid opt-out affidavit after June 16, 2015, and don't want to extend their opt-out status at the end of the two-year period can cancel by notifying in writing all Medicare contractors with which they filed an affidavit at least 30 days prior to the start of the next two-year opt-out period.

For additional information, click  here
Survey: Most U.S. dentists support adding dental to Medicare
Dr., November 21, 2018
A majority of respondents to a survey of 20,000 U.S. dentists support adding dental coverage to Medicare, according to research from the ADA's Health Policy Institute (HPI) and Oral Health America. The survey findings were presented at the recent American Public Health Association (APHA) annual meeting in San Diego.
Janicia Sanchez is one of Delta Dental of Colorado's provider network advocates. She brings to our team a wealth of experience and enthusiasm, along with a great attitude while helping to serve our providers. 

Tell us about yourself. 
I consider myself to be a Colorado native. 2018 has been a big year for me! I recently purchased my first house and got engaged this summer. I have been in the dental field for a little more than six years working in dental administration with cross-training in dental assisting. I have always had a fascination with teeth and dental procedures but my passion is for the administrative side of dental.

What do you enjoy most about working with the dental community?
I love how the dental community has the ability to change people's appearance, both physical and perceptual.

What's the best part about your job at DDCO?
The best part of my job is being able to find solutions and assisting offices in making their jobs a little easier.
EYP Quick Fact
The Department of Veterans Affairs only offers dental care for veterans who are 100% disabled or have service-connected injury to their mouth. The CU Heroes Clinic is helping offer free and discounted dental care for those who have served in the armed forces. 

Delta Dental of Colorado