How Credentialing Works for YouAs part of our commitment to quality,DeCare Dental has a formalized credentialing/recredentialing processthrough which we objectively evaluatedentists against formalized standards.

DeCare Dental’s credentialing programreassures subscribers that we engage in a thorough validation process beforeaccepting member dentists. This meansthat consumers are more likely to choosea DeCare Dental dentist, increasing a participating provider’s patient base.

In addition to quality, the credentialing/recredentialing process is the first step in assuring that a dentist’s claims are paidproperly. The credentialing staff verifies a dentist’s clinic name, addressand tax ID information and compares it toexisting data already on file. Once all thedentist’s information is validated and the credentialing/recredentialing process has been completed, the information isreconfirmed and loaded into our system.

A new dentist can expect this process totake approximately one week from thetime the credentialing application andcontracts are received at DeCare Dental,provided there is no missing information.

DeCare Dental has worked closely withdentists to find ways to streamline thecredentialing process. For example, wenow have the ability to pre-populate the dentist’s information in the DentalDatabase Report as part of the recredentialing packet, saving the dentist valuable time.

Here are some helpful tips for you toensure that the credentialing process is quick and easy:1. Write legibly on the credentialing/

recredentialing application.2. Complete application accurately

(i.e. correct spelling of name, date of birth, graduation date, etc.)

3. Include current copies of supporting documents such as professional liability insurance declaration page, license, DEA, etc.

4. Review disclosure questions carefully, being mindful of answers, and include a complete explanation to any “yes” answers.

5. Utilize postage paid envelopes to return credentialing application and supporting documents to credentialing staff in a timely manner.

Spring 2007

INSIDETHIS

ISSUE:

Visit us on the Web:

www.decare.com/ddnoffice

CUSTOMER SERVICECONTINUES TO EXCEL

Meet the Recruitmentand Retention Staff ACT NOW!

If you submit claims electronically, NOW is the time to apply for your NPI. See the insert page for instructions and a fax-back form to notify us of your NPI.The deadline is May 23, 2007.

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Although rare, life-threatening medicalemergencies can occur in any health-care setting, including dental offices.Medical emergencies can cause confusion and distress for both the patient and the dental staff.

As recommended by the AmericanDental Association (ADA), dentaloffice staff must be prepared to recognize and properly manage medical emergencies in the dentaloffice. Each member of the dentalstaff must be aware of the protocoland their individual responsibilitiesduring an emergency.

Steps To Avoid EmergenciesIt is estimated with proper preventiontechniques, such as being familiarwith a patient’s medical history and implementing effective stress-reduction procedures, many life-threatening medical emergencies can be avoided. Medical emergencypreparation begins by taking thepatient’s detailed medical history atthe time of the initial appointment and regularly thereafter. The dentistas well as the patient should sign and date the initial medical historyform as well as any notations made during future (follow up)appointments.

Medical alerts such as allergies,hypertension, diabetes, etc. should beindicated in the chart to alert dentalstaff each time chart notes arereviewed, while maintaining thepatient’s privacy. It may be necessaryto consult the patient’s physician foradditional information concerningmajor health risks, such as cardiacconditions or history of stroke.

Basic Emergency KitEach office should have a medicalemergency kit that should be appropriate for the patient populationand the nature of your practice. TheADA emphasizes the importance thatthe dentist be knowledgeable aboutthe indications, contraindications,dosages and methods of delivery forall items included in the emergencykit.

The ADA indicates that emergency kitdrugs should include only what thedentist and staff are familiar with andable to employ. The ADA suggeststhat the following drugs be includedas a minimum in an emergency kit:

• Epinephrine 1:1000 (injectable)

• Histamine blocker (injectable)

• Nitroglycerin (sublingual tablet or aerosol spray)

• Bronchodilator (asthma inhaler)

• Sugar

• Aspirin (chewable)

• Oxygen with positive pressure administration capability

Other drugs may be included in the emergency kits if the doctor’straining and needs mandate them.

The ADA recommends that dentistsshould perform continual medicalemergency kit maintenance by replacing soon-to-be outdated drugs before the expiration date.

Equipment must be stored in a readilyaccessible location. It is important for

a member of the dental staff to beassigned to check and maintain theequipment on a routine basis. Inaddition, it is important for the dentalteam to maintain current knowledgeof the medications in the emergencykit located in each office, as well ashow to handle emergencies by conducting regular refresher coursesto maintain a high state of readiness.

When an Emergency OccursMedical situations are not always preventable and the dental clinic staffneeds to be prepared to act quicklyduring an emergency. Emergencynumbers should be posted on all telephones. It is also important todetermine who will be called to assistin an emergency situation (usuallyEMS – 911) and how long it will take for help to arrive.

Dentist and staff should all have current provider certificates in BasicLife Support. It is also recommendedthat they take didactic and hands-ontraining in the prevention, recognitionand management of common medical emergencies.

For offices where emergency medicalsystem personnel with defibrillatorskills and equipment are not availablewithin a reasonable time, the ADA recommends that the dentist maywant to consider an automated external defibrillator (AED) consistentwith AED training acquired in theBasic Life Support section of healthcare provider courses. The ADA also recommends that for certain individuals, additional training inadvanced cardiac life support, pediatric advanced life support or both may be warranted.

Medical Emergencies: Is Your Office Prepared?

References: Office emergencies and emergency kits: ADA council on scientific affairs. JADA, Vol. 133, March2002 Malamed, SF. Medical emergencies in the dentaloffice. 5th ed. St. Louis: Mosby; 2000.

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As a participating dentist in thenational network, it is importantthat you inform DeCare DentalNetworks (DDN) of changes toyour practice location or tax IDchanges. This information is vitalfor accurate claims processingand payment.

Please submit practice changesin writing to:DeCare Dental NetworksAttention: Provider RelationsP.O. Box 1175Minneapolis, MN 55440-1175

Changes can also be faxed to(800) 658-4186.

DeCare Dental Networks recentlyadded FCA (Fellowship of ChristianAthletes) to its customer base.Founded in 1954, FCA is headquartered in Kansas City, Mo.and has approximately 650 employees nationwide.

If you would like a copy of the benefit plan, contact a DeCare DentalNetwork representative at (800) 658-4187.

Performance Category Performance Standard Year-to-Date Performance

Phone Response TimeThe average number of seconds 30 seconds average speed 8 secondsfor customer service to answer of answerthe phone.

Claim Turnaround TimeNumber of days between receipt 85% in 14 calendar days 95.9% in 14 calendar daysof claim and adjudication.

Tips and RemindersIn order for a claim to be paid to the correct dentist in an accurate and efficient manner, please remember the following important items:

Group Number:FCA (Fellowship of Christian Athletes) group number is 8701 in plan 650.This information is found on the member’s ID card.

Billing Address: The billing address must match the addressthat was submitted by the billing dentist ontheir DeCare Dental Networks application.

Electronic Claims Submission: Submitting claims electronically is easy andefficient. When submitting claims electronically,use the submission code 07035 (also called apayor ID). If you need a copy of the Electronic Claims Submission Guide, please call aDeCare Dental Networks Representativeat 1-800-658-4187.

When filing claims, don’t forget to submit theoffice's Usual & Customary (UCR) charges.

Have YouMovedRecently? It’s Critical toLet Us Know

Visit us on the Web

DeCare Dental Networks AddsAnother Customer

Customer Service Continues to Excel

DeCare Dental Networks Customer Service Stats

Don’t forget to visit our Web site,www.decare.com/ddnoffice, to find out more about theDeCare Dental Network or for oral health information, information on submitting claims, participating specialists,frequently asked questions and forms & literature amongnumerous other topics.

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P.O. Box 1175Mpls, MN 55440-1175

The Office Link is published for dentists participating in DeCare Dental Networks. Article ideas and questions from readers are welcome. Please contact Heather Hofmeister, Corporate Communications, at hhofmeister@decare.com.

DeCare Dental Networks Quick GuidePurpose Contact

General Info: National Dentist Professional Services’ National Network Networks Representatives: 1-800-658-4187

General Information Regarding Customer Service: 1-800-587-6857Claims, Member Eligibility Verification, Network Specialists andMember Questions

Mail Claims/Pre-Estimates DDHIP.O. Box 1348Minneapolis, MN 55440-1348

Mail Provider Info/Change DDNof Address P.O. Box 1175

Minneapolis, MN 55440-1175

The Professional Services Staff for national networks at DeCare Dental Networks is committedto building a long-term relationship with contracted dentists. We offer the highest level of customer service and have representatives available to take your calls Monday through Friday.If you happen to leave a message, we will return your call within 24 hours.

Your DeCare Dental National NetworkProfessional Services Staff: Deb Reeves,Dave Cook (Director), and Sarah Michaels.

Meet Sarah Michaels. Sarah began working with DeCare in August 2006, after working in the corporate brandingindustry. Sarah graduated from theUniversity of Minnesota with a BachelorsDegree in Human Resources. Her interests include reading, traveling, skiing and being outdoors.

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