HCPro.com: Managed Dental Care

This monthly newsletter features 12 pages of business news and analysis on matters affecting every dental payer, provider, supplier, and DPM in the country.

To view the entire newsletter issue, click the “View Entire Issue” link below

November 2007 (Volume 12, Issue 11)	view entire issue

Network development requires new approach
Building a provider network is a different task today than it was just half a decade ago, but it's still required for competitive managed care products. Now, experts say, network construction isn't simply swapping lives for discounts. Rather, dental plans today must service their panel providers if they want to keep their members happy. "Network development has become more challenging over the last five years," says Richard Goren, DDS, second vice president of group dental at The Guardian Life Insurance Company of America in New York City.

New Delta Dental benefit reflects integration in action
A recent benefit enhancement from Delta Dental of Michigan, Ohio, Indiana, and Tennessee, in Okemos, MI, expands group coverage for patients with certain heart conditions to help them avoid infective endocarditis, a deadly heart infection. The Delta Dental plan is the first dental benefits carrier in the United States to offer such coverage. The only problem, says one expert, is that the hype around important benefit design changes to reflect closer medical-dental integration exceeds the desire for such programs on the part of employers.

Claims software needn't be a tough sell to providers
Technological advances in claims fraud detection software have made adoption of such systems de rigueur for dental plans of all sizes. But prevalence among plans doesn't necessarily equal popularity among providers. The dentists whose claims are being double-checked for accuracy may not appreciate the implication or the effect. A simple sentence should explain the situation to them though: "Fair's fair." Dental Select, a dental plan in Salt Lake City with operations throughout Utah, Texas, and Nevada, has signed with HealthCare Insight (HCI) in Sandy, UT, a provider of clinically validated fraud prevention and cost containment solutions, to help maximize its payment accuracy.

Principal's network buy poses risks, benefits
The Principal Financial Group in Des Moines, IA, has acquired Diversified Dental Services (DDS), Inc., a Nevada-based independent dental PPO (DPPO). Although such a tactic for network building is quicker than assembling a panel from scratch, it comes with its own set of challenges, experts say. Combining claims systems and, especially when the paired products are a DPPO and a dental HMO (DHMO), member services operations can be an especially tricky endeavor. The DDS acquisition furthers The Principal's national dental network strategy of offering more providers and better pricing for members and business partners, says Deanna Strable, senior vice president of the specialty benefits division there.

Other recently-published articles from Managed Dental Care:

Managed Dental Care 2008 index

Oral care’s glam mag

GAO: Young Medicaid enrollees at risk for tooth decay

A theory, in practice

A hothouse for dental care

NADP consumer survey reveals perceptions

Delta plans change policy on nonreimbursed care

The executive dentist

Making do

Striking from the Heartland

Oral care at a distance

Water tumbler

Three big insurers enter individual market

Gummed up?

Simulators likely to make inroads in production, education

ABOUT HCPRO

PRESS

CAREERS @ HCPRO

ADVERTISING OPPORTUNITIES

ONLINE STORE

200 HOODS LANE

P.O. BOX 1168

MARBLEHEAD, MA 01945, USA

PHONE: 800/650-6787

FAX: 781/639-7857

Copyright Statement	Privacy Policy

*MAGNET™, MAGNET RECOGNITION PROGRAM®, and ANCC MAGNET RECOGNITION® are trademarks of the American Nurses Credentialing Center (ANCC). The products and services of HCPro, Inc. and The Greeley Company are neither sponsored nor endorsed by the ANCC