P.E.R.I.O.: Patient Empowerment to Reduce Inferior Outcomes

This webinar reviews key strategies to emphasize the impacts of periodontal disease on oral and overall health and the critical importance of effective and timely diagnosis and treatment as well as optimal strategies for long-term maintenance of treatment outcomes. Tuesday, July 16, 2024 @ 7 p.m. ET

More information here.

Recoupment of Interim Payment:

The Department of Social Services (DSS) has been monitoring claim levels for all providers that received an interim payment due to the Change Healthcare Cyber Attack and has determined that most providers are back to normal payment levels based on their claim cycle payments in April and May. Those providers determined to be back at their normal payment levels will have the full interim payment recouped in the May 24, 2024 claim cycle. Providers will see this in their Remittance Advice (RA) dated May 29, 2024. DSS will continue monitoring all other provider claim levels. Providers should expect to see the interim payment recouped in full in a future claim cycle, no later than September 30, 2024.

A new workshop has been scheduled for newly enrolled providers or new business office staff. The workshop will be presented virtually, on June 12th at 9:30am by the Department of Social Services and Gainwell Technologies. Registration due date is June 6th.

View the invitation here.

A funding assistance program is available to dentists impacted by the cyberattack on Change Healthcare.

The Feb. 21 attack is preventing many dentists from sending electronic claims and attachments to insurance companies to receive payment. Change Healthcare, owned by UnitedHealth Group, is one of the largest health care technology companies in the U.S.

Read more here.

In response to the reimbursement interruption and impact caused by the Change Healthcare Cyberattack incident and in accordance with federal Medicaid guidance from the U.S. Centers for Medicare and Medicaid Services, the Department of Social Services (DSS) will be accepting interim payment requests from affected providers in order to maintain a continuation of care to members without interruption.

Read More Here.

Cybersecurity expert Gary Salman offers insight on what causes data breaches and how they relate to dental practitioners, including obvious signs a cybersecurity incident has occurred and practical ways dental offices can prevent data breaches from happening. “Many practices still harbor a broken mindset, meaning they believe they are immune to breaches, thinking that it won’t happen to them,” he said.  Read the ADA Article Here.

Noninferiority of Silver Diamine Fluoride vs Sealants for Reducing Dental Caries Prevalence and Incidence A Randomized Clinical Trial

Ryan Richard Ruff, PhD, MPH; Tamarinda J. Barry Godín, DDS; Richard Niederman, DMD

Dental caries is the world’s most prevalent noncommunicable disease and a source of health inequity; school dental sealant programs are a common preventive measure.
Silver diamine fluoride (SDF) may provide an alternative therapy to prevent and control caries if shown to be noninferior to sealant treatment.  Read more here.

All Gainwell Provider Updates here.  The most recent update was issued on 2/29/24.

Emergency Prior Authorizations may be called into the Provider Services Prior Authorization line at 888-445-6665.

For claims payment related issues, please call the Gainwell Helpline at 800-842-8440.

New! Temporary Process to Receive Client Eligibility Status, Claims History and Adult Benefit Maximum Data from CTDHP: Providers can contact the Member Service Center to receive Patient information on 5 or fewer patients per call. Please call 855-283-3682. And, have the following information ready for CTDHP: Client Name, Medicaid ID, Date of Birth, Provider NPI.

Providers can also complete this form and fax to CTDHP at 860-674-8174 to receive information for 6 or more patients. You can provide multiple copies of the form.

CTDHP will return via fax the completed information. Faxes will be processed in the order received and completed within 4 hours of when the fax was received. Any faxes sent to CTDHP after 4pm will be processed and sent the next business day.

Prior Authorization and Post Procedure review can be submitted via standard mail. The J434 Standard ADA Claim Form and all required supporting documentation may be sent to CTDHP/BeneCare at:

CT Medicaid Prior Authorization

C/O Dental Benefit Management/BeneCare
555 City Ave East Suite 600
Bala Cynwyd, PA 19004
Orthodontic Prior Authorization requests can be sent to:

Orthodontic Case Review
C/O BeneCare Dental Plan
195 Scott Swamp Road, Suite 101
Farmington, CT 06032

Please note, decisions regarding the Prior Authorization requests are provided within fifteen business days of receipt.