April 2019

IMPORTANT UPDATES 
Child Health Plan Plus Transition
As we recently communicated, Delta Dental of Colorado did not bid on a new contract for the combined administration of dental benefits for the Child Health Plan Plus (CHP+) and Medicaid programs. Our current contract will expire on June 30, 2019, and DentaQuest will be taking over as the dental administrator for the CHP+ program. 

You will need to contract with DentaQuest in order to continue servicing CHP+ subscribers and submit claims related to CHP+ and/or Medicaid to them as of July 1, 2019. You can visit their website dentaquest.com/dentists/ or contact the provider relations representative for your area for information on contracting and more. In addition, providers are still required to revalidate with the State of Colorado. You can do so by visiting colorado.gov/hcpf/provider-enrollment.

Northeastern Colorado
Donna Phelps
Southern Colorado
Richard Spencer
Central/Metro Denver
Lisa Larkin-Allen
Western Colorado
Christie Robson

In addition to the transition of administration of the CHP+ dental program, we will also be discontinuing the Delta Dental of Colorado Fund for groups 8883 (CHP+) and 8884 (DDCO subscribers at a certain percentage of the federal poverty level). The DDCO fund will be closed as of July 1, 2019, and any associated treatment must be completed by June 30, 2019. If you have questions regarding the fund, please contact our network provider management team at 303-889-8677 or provideradvocate@ddpco.com

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Adult Prophylaxis vs. Periodontal Maintenance
There are differences between prophylaxis treatment and periodontal maintenance. Many patients and even dental offices have used them interchangeably, it's atypical for a patient to actually be able to switch between a treatment that is purely preventive (prophylaxis) with one that is considered post-therapeutic (periodontal maintenance) once the patient has been diagnosed with gum disease. 

We encourage you and your office staff to make your patients aware of the differences between these two treatments from a cost and clinical perspective. Code D1110 (prophylaxis) is typically covered at 100% since it is a preventive measure, but code D4910 is typically covered at 80%, requires a copay, and requires the balance to be paid by the patient, subject to group benefits. 

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The Right Start for a Bright Future with Right Start 4 KidsĀ®
Right Start 4 KidsĀ® (RS4K) from Delta Dental of Colorado is a unique plan enhancement that removes most of the cost barriers to dental care by providing coverage for children up to their 13th birthday at 100% coinsurance for diagnostic & preventive, basic, and major services, with no deductible, when in-network providers are seen. 

RS4K is included in over 75% of all group plans! Download the RS4K flyer here

Benefit summaries will show the following (i n bold ) when a RS4K benefit is available for a child under 13*:

Benefit
We Pay
PPO I Premier I Non Par
Deductible 
PPO I Premier I Non Par
Waiting Period Satisfied
Orthodontic image (D0240, D0350)
100% I 100% I 0% No I No I No Satisfied
Orthodontics w/o Images
50% I 50% I 0% No I No I No Satisfied
Special Restorative (Crowns)
100% I 100% I 0% No I No I No Satisfied
Std E (No Special Restorative) Major
100% I 100% I 0% No I No I No Satisfied
Std E Basic
100% I 100% I 0% No I No I No Satisfied
Std E D&P
100% I 100% I 0% No I No I No Satisfied
Std E Endo/Perio/Oral Surg
100% I 100% I 0% No I No I No  Satisfied

*Benefit summary could reflect similar coverage information for members who are older than 13 but have similar coverage and for group plans that don't include RS4K 
INDUSTRY NEWS
Boulder-area oral surgeons see success with new nonopioid strategies
The Denver Post, February 24, 2019
Boulder and Lafayette oral surgeons who started using a new strategy to sedate and treat pain in patients to reduce their use of opioids say it has been successful so far.

The Frontier Center , an award-winning program at the University of Colorado School of Dental Medicine, was created through an initial gift from Delta Dental of Colorado Foundation . Working in partnership with CU, the two organizations brought to life a vision to train the future health care workforce on the connection between oral health and overall healthThe Frontier Center educates medical, dental, and pharmacy students on how oral health can impact overall health and vice versa. 

Delta Dental of Colorado
1-800-610-0201