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Coronavirus: Updated guidance for dental providers

 

Updated March 28, 2020

ODS Community Dental understands the disruption and uncertainty our providers are facing due to coronavirus (COVID-19) and would like to share resources to keep you informed.

On March 19, the State of Oregon mandated that all dental professionals suspend and postpone all elective and non-urgent oral health procedures until June 15 for the purpose of conserving and redirecting personal protective equipment (PPE) state’s COVID-19 emergency response. 

Prioritization should focus on treatment for patients experiencing dental emergencies, as defined by the American Dental Association (ADA):

Delta Dental of Oregon and Alaska PPE Reimbursement

As dental offices begin to re-open to resume non-emergency dental services, ODS Community Dental is aware of the increased costs associated with following additional safety measures during in-office visits.

We are pleased to announce that we will be providing temporary PPE assistance for private practices in the amount of $7 per in-office visit occurring between June 1 and Aug. 31, 2020.

In order to receive reimbursement for PPE, submit a claim as you ordinarily would for services provided and include the following code:

  • D1999 – Miscellaneous

Reimbursement is not available for patients on an OHP capitated dental plan or for patients treated by a corporate dental practice.

Please note that you cannot bill patients directly for PPE.

For more information, please contact ODS OHP Dental Customer Service at 800-342-0526.

ODS Community Dental loan program

In an effort to ease financial burdens dental providers and their offices are experiencing due to the current public health emergency, ODS Community Dental is offering funding to participating providers through its financing arm, Astra Practice Partners and Dental Commerce Corporation (Astra).

Participating providers can now apply for a loan up to $20,000 to help shoulder the economic impact to their practices as a result of COVID-19. Terms and rates of loans will be based on the applicant's credit score.

To apply, providers must submit a completed Astra Loan Application and business debt schedule along with copies of their:

  • Dental license
  • Driver's license
  • Articles of Incorporation or Operating Agreement

Send completed applications and accompanying documentation to:

Dental Commerce Corporation
Attn: Greg Hansen
601 S.W. Second Ave.
Portland, OR 97204

You can also submit applications and documents via fax at 503-952-5288 or email them directly to info@dentalcommercecorp.com

The deadline for applications is June 30, 2020.

Tele-Dentistry and Processing Update

Delta Dental of Oregon is aware of the challenges facing dental offices given the restriction of allowed services under Governor Brown’s Executive Order 20-10. We understand providers may rely on the use tele-dentistry during this time in lieu of an in-person visit.

DDOR will benefit limited oral evaluations completed via tele-dentistry during the period of mandated restriction of services.

Please submit the claim using CDT code D0140 Limited Oral Evaluation - problem focused, to describe the treatment rendered. Reimbursement will be based on your contracted fees.

If you are conducting the exam via tele-dentistry, we ask that you include the corresponding location code based on whether the encounter took place in real-time:

D9995 teledentistry – synchronous; real-time encounter
D9996 teledentistry – asynchronous; information stored and forwarded to dentist for subsequent review

Please note that the above tele-dentistry codes (D9995 and D9996) are still considered inclusive of the exam.

Frequency Limitations: Limited exams will not impact coverage for a recall or comprehensive exam later in the year.

Please be mindful of maintaining appropriate chart notes for these encounters in accordance with current Oregon Board of Dentistry dental record keeping requirement in the Dental Practice Act.

Dental emergency
Dental emergencies are potentially life threatening and require immediate treatment to stop ongoing tissue bleeding, alleviate severe pain or infection, and include:  

  • Uncontrolled bleeding
  • Cellulitis or a diffuse soft tissue bacterial infection with intra-oral or extra-oral swelling that potentially compromise the patient’s airway
  • Trauma involving facial bones, potentially compromising the patient’s airway 

Urgent dental care 
Urgent dental care focuses on the management of conditions that require immediate attention to relieve severe pain and/or risk of infection and to alleviate the burden on hospital emergency departments. These should be treated as minimally invasive as possible.  

  • Severe dental pain from pulpal inflammation
  • Pericoronitis or third-molar pain
  • Surgical post-operative osteitis, dry socket dressing changes
  • Abscess, or localized bacterial infection resulting in localized pain and swelling.
  • Tooth fracture resulting in pain or causing soft tissue trauma
  • Dental trauma with avulsion/luxation
  • Dental treatment required prior to critical medical procedures 

You can find more information regarding these announcements by  visiting the ADA and the Oregon Dental Association (ODA) websites.

We recommend also visiting the Oregon Health Authority (OHA) and the Centers for Disease Control (CDC) websites for more information and treatment guidelines related to COVID-19.

We also want to assure you that we are dedicated to business continuity during the outbreak. We have a large number of employees across the organization that work from home on a full or part-time basis and have increased that capacity. We are fully operational and are committed to processing claims in a timely manner. Customer service is available during our regular scheduled hours. 

We appreciate your partnership and look forward to continuing to work together throughout this challenging time. We will continue to provide updates as things develop.


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