FYI

What better way to close out 2022 than make sure you’re ready for 2023? Here’s a helpful list of six tasks to complete before the year ends to make sure you hit the ground running in January.
 

1. Complete your re-credentialing (if applicable)

You may have received a letter from us recently about re-credentialing. If so, your re-credentialing may be due. We’re required to confirm at least once every three years that our network dentists are properly qualified, so be sure to complete and return your re-credentialing form. We must terminate your contract if your credentials expire. (Be sure to let us know if the letter you received is for a dentist who’s no longer at your practice location.)

Beginning January 1, 2023, any of the following will result in ineligibility for credentialing or re-credentialing. We won’t be able to process your application and you may be subject to termination:
 

• Active limitations or sanctions, including probation, imposed by a state dental board or licensing agency
• For re-credentialing: Criminal convictions related to competence, professional misconduct or moral turpitude within past five years
• For initial credentials: Criminal convictions related to competence, professional misconduct, or moral turpitude within past 10 years
• Failure to maintain sufficient professional liability insurance
• Current exclusion or restriction by any federal or state agency from participating in a government-sponsored program that provides health benefits, including but not limited to Medicare or any state Medicaid program or any DHMO network
   

2. Complete your fraud, waste and abuse training by December 31

Are you a Medicare Advantage dentist? If so, you’ll need to complete your annual General Compliance and Fraud, Waste and Abuse (FWA) certification. This includes finishing the FWA training and ensuring your practice has a written ethics guide and code of business conduct. But not to worry — you can find the steps you need to take here.

If you’re not a contracted Medicare Advantage provider and are interested in joining the network, please email us at MedAdv@delta.org for PPO and ProviderConcierge@delta.org for DHMO.
 

3. Update your dentist directory information

Ensure your information is accurate and up to date in our dentist directory. You can easily revise your practice information by following these steps:
 

1. Log in to your account. (If you don’t have an online account, please register.)
2. Select My Account, and then select Directory Profiles.
3. Select Open next to the applicable location.
4. Verify and update the information and click Submit.
5. Repeat these steps for each applicable location.
    

If you need to update your office’s mailing or email address, please use the  Notice of Address Change form.
 

4. Verify your taxpayer identification number (TIN)

To ensure that your Delta Dental earnings are properly reported to the IRS, please confirm that we have your correct TIN in our files. Check the last four digits of your TIN on page 1 of the claim payment documents you receive from us.

If they don’t match the TIN you have on file with the IRS, let us know immediately. Use the  TIN enrollment form (PDF) to report any updates or corrections.
 

5. Encourage your patients to max out their benefits by year’s end

Some of your patients may not have met their annual maximum and may still be eligible for diagnostic and preventive services. Remind your patients to get their cleanings and exams before their plans reset with the new calendar year. (And remember, all Delta Dental plans cover diagnostic and preventive service at low cost or no cost for members.)

If you have patients who have reached their annual maximum and still need non-urgent care, encourage them to make appointments now for early in the new year. This way, they can get the services they need as soon as possible while taking advantage of their plan coverage.
 

6. Get ready for 2023 CDT codes

A new year means parties, champagne, resolutions and, of course, new CDT codes. The 2023 CDT update features 29 new codes (including seven post-publication inclusions in CDT 2022), two code deletions and 14 nomenclature and description revisions. Don’t forget to use the new codes on all claims for services provided on or after January 1, 2023.

A PDF summary of these changes, including CDT 2023, is  available to download.

An updated version of the Dentist Handbook with the new CDT codes will also be available in the Provider Tools Reference Library starting December 1, 2022. This new version will include a summary page to highlight any updates and changes made throughout the Handbook since the previous version.

Check all the boxes on this list to be a dental rock star in 2023! Have questions? Contact Provider Concierge at 800-592-0156, Monday through Friday, 7 am to 5 pm PT. You can also email us at providerconcierge@delta.org. Have a great rest of 2022!