COVID-19 update: We're responding in a variety of ways to support our employees, customers, network dentists, and our fellow South Dakotans. Learn more.

Pandemic financial support programs

DDSD offers two financial support programs to help our participating dentists through the unprecedented disruption in providing dental care. Six exam fee codes have also increased to offset PPE needs, and certain teledentistry services are now being covered. Select the tab below for more information.

Details of the Reimbursement Advance Program and application form were issued on Tues., March 31, 2020. Details of the Loan Assistance program were issued Fri., April 17.  Information about exam fee increases were issued Mon., May 4.

 

Exam fees increased 6% to support offices' added PPE costs

Recognizing the impact of the COVID-19 pandemic, Delta Dental of South Dakota (DDSD) has increased reimbursement for six different exam codes by an average of 6% to help offset offices' new added PPE costs. The exam codes are:

  • D0120
  • D0140
  • D0145
  • D0150
  • D0160
  • D0180.

The fee increase is effective May 1 ,2020. 

Billing for infection control

Costs for infection control and OSHA compliance are included in the DDSD fees for the dental services provided and will continue to be so. As noted in the General Policies section of the 2020 Dentist Handbook, a separate fee for infection control is not billable to the patient by a DDSD participating dentist.

Loan Assistance Program

The Loan Assistance Program offers interest-free, forgivable loans to dental practices that don't have a sufficiently strong financial position to sustain the practice through the recommended COVID-19 practice restrictions. The DDSD Board of Directors has approved up to $1 million to be made available for the loan program. The program is voluntary, and all interested practices will need to apply by May 5, 2020.

Overview

  • The Loan Assistance Program is intended for dental practices that face substantial financial challenges during the COVID-19 pandemic, especially considering factors like:
    • recent purchase of practice;
    • recent business expansion or renovation;
    • recent investment in new equipment or technology; and
    • other financial commitments.
  • Priority will be given to practices with strong participation in the SD Medicaid program.
  • Approved solo practices will receive between $10,000 - $20,000 based on need and 2019 Medicaid patient volume.
  • Approved group practices will receive $20,000.
  • Portions of the loan may be forgiven if the practice meets criteria as outlined below under Loan forgiveness criteria.
  • Each practice is eligible for up to four (4) of the loan forgiveness criteria for total loan forgiveness of up to 100%.
  • The loan assistance will be in addition to any ongoing reimbursement payments, such as claims payments for emergency care, as well as any reimbursement advances through the Reimbursement Advance Program.
  • Eligible practices can apply for both the Reimbursement Advance and Loan Assistance pandemic financial support programs.

Application and payment timeline

  • An application is needed to participate in the Loan Assistance Program.
  • Applications are due Tuesday, May 5, 2020.
  • When an application is approved, the practice will receive notification.
  • DDSD will notify practices of application approval using the email listed on the application.
  • Loan assistance payments will be made on or around May 20, 2020.
  • All payments will be made using Electronic Funds Transfer (EFT). If your practice does not currently receive claims payments from DDSD using EFT, the practice must enroll with a DDSD Direct Deposit Enrollment Form, available in paper or online enrollment form.
  • If your practice currently receives claims payments from DDSD using EFT, payments will be sent to the EFT information on file.
  • Any loan amounts not forgiven will be repayable on or before July 1, 2021 by direct payment to DDSD.

Loan forgiveness criteria

  • Practices with a 2019 patient load that included at least 30% patients with Medicaid coverage and that maintain or increase that ratio between July 2020 and June 2021 will receive forgiveness of 25% of their loan.
  • Practices with a 2019 patient load that included between 15%-30% patients with Medicaid coverage but increase the case load by 50 patients for a solo practice or 100 patients for a group practice between July 2020 and June 2021 will receive forgiveness of 25% of their loan.
  • Practices conducting business with DDSD entirely electronically, including electronic claim and attachment submission, electronic explanation of benefits (EOB), and electronic funds transfer (EFT), will receive forgiveness of 25% of their loan.
  • Practices actively participating in Health through Oral Wellness between July 2020 and June 2021 will receive forgiveness of 25% of their loan.
  • Practices participating the DDSD PPO network between July 2020 and June 2021 will receive forgiveness of 25% of their loan.

Loan forgiveness verification

  • Practices are asked to indicate which loan forgiveness criteria they intend to meet on the initial application.
  • Verification of practice compliance with loan forgiveness criteria will be done using DDSD claims data and practice attestation.
  • In May/June 2021, DDSD will send each approved practice information concerning the loan forgiveness criteria. Practices must return any requested information before the loan portion(s) will be forgiven.
  • DDSD will generate a 1099 in 2021 for any portion of the loan which is forgiven. The practice receiving the loan forgiveness is responsible for any resulting taxes.

Qualifications

  • Dental practices must be DDSD network participating practices.
  • A limit of one (1) application will be accepted from each Business Tax ID Number (TIN).
  • All dentists associated with the application must be listed on the application.
  • Dentists associated with more than one TIN can only be listed on one application.
  • Applications will not be accepted from Indian Health Service dental offices.
  • If a dental practice has a change in ownership or TIN number at any time prior to July 1, 2021, the non-forgivable portion of the loan will be assigned to the new business unless otherwise arranged.   

How to apply

Applying is easy in 2 simple steps. DDSD will notify practices of application approval using the email listed on the application.

Step 1
Complete the application form in its entirety, and sign it.

Step 2
Submit the signed, completed application using one of the following methods:

Fax

605-494-2566

Mail

Delta Dental of SD
Attn: Loan Assistance Application
PO Box 1157
Pierre, SD 57501

Reimbursement Advance Program

The Reimbursement Advance Program is intended to provide dental practices a cash flow to help cover the operating expenses of the practice. This program is voluntary, and all interested practices will need to apply.

Overview

  • Reimbursement advance is available for April and May, 2020.
  • Solo practices can receive $10,000 per month for a total of $20,000.
  • Group practices can receive $20,000 per month for a total of $40,000.
  • Advance payments will be recovered by Delta Dental of South Dakota in twenty (20) equal payments starting with the June 10, 2020 check run and continue through December 20, 2020.
  • Any advance payments not collected by December 20 will be subject to a final settlement on December 31, 2020.
  • The monthly advances will be in addition to any ongoing reimbursement payments, such as claims payments for emergency care.

Application and payment timeline

  • A single application is needed to participate in the program for both months.
  • Applications received and approved on or before April 10, 2020 will receive the April advance payment on or around April 15, 2020.
  • Applications received and approved between April 11 – April 25, 2020 will receive the April advance on or around April 30, 2020. 
  • Applications received and approved after April 25, 2020 will receive only the May advance on or around May 15, 2020.
  • All May advance payments will be received on or around May 15, 2020.
  • All payments will be made using Electronic Funds Transfer (EFT). If your practice does not currently receive claims payments from DDSD using EFT, the practice must enroll with a DDSD Direct Deposit Enrollment Form, available in paper or online enrollment form.
  • If your practice currently receives claims payments from DDSD using EFT, payments will be sent to the EFT information on file.
  • DDSD will notify practices of application approval using the email listed on the application.

Recovery process

  • Starting with the June 10 check run, $1,000 or $2,000 per check run will be deducted from the claims payments for participating solo practices and group practices respectively.
  • If the practice recovery designee(s) have less than $1,000 (solo practice) and less than $2,000 (group practice) in claims payments during one or more check run during the recovery time period, DDSD will deduct the entire claim amount and the remainder will be totaled for the final settlement on December 31, 2020.
  • Dental practices may submit a check with complete repayment at any time during the repayment period.

Qualifications

  • The dental practice must be following the CDC and ADA recommendations to suspend procedures except for emergency care.
  • Dental practices must be DDSD network participating practices. 
  • A limit of one (1) application will be accepted from each Business Tax ID Number (TIN).
  • All dentists associated with the application must be listed on the application.
  • Dentists associated with more than one TIN can only be listed on one application. 
  • Group practices must designate one or two dentists from whom DDSD will recover the advance claims payments beginning June 10.
  • The dental practice must be a private entity. Applications will not be accepted from Community Health Center or Indian Health Service dental offices.
  • Dental practices must be located in South Dakota and the majority owner(s) must have an active South Dakota license from the SD Board of Dentistry. 
  • If a dental practice has a change in ownership or TIN number at any time during the repayment period, the remaining payments will be assigned to the new business unless otherwise arranged.  

How to apply

Applying is easy in 2 simple steps. DDSD will notify practices of application approval using the email listed on the application.

Step 1
Complete the 1-page application form in its entirety, and sign it.

Step 2
Submit the signed, completed application using one of the following methods:

Fax

605-494-2566

Mail

Delta Dental of SD
Attn: Reimbursement Advance Application
PO Box 1157
Pierre, SD 57501

 

March 24, 2020
 

A message from Scott Jones
 

Dear DDSD Participating Dentists,

First and foremost, we hope that you, your families, your staff, and your patients are staying healthy during this time of uncertainty and change. COVID-19 is impacting nearly every aspect of our lives, and we understand that the ADA recommendation to limit services to emergency treatment will likely result in significant financial strain, especially for the next two months.

With that in mind, the DDSD Board of Directors approved two programs to provide financial support to DDSD participating dentists’ practices.  Dentists’ practices may participate in both programs.

  • The DDSD Reimbursement Advance Program will advance up to $8 million total of future clinical reimbursement payments to dental practices in April and May. The program is intended to provide dental practices a cash flow to help cover the operating expenses of the practice. These advance claims payments will be recovered by DDSD starting this summer as practices return to a more normal work schedule. The program is voluntary, and all interested practices will need to apply.

Advance amounts will equal $10,000 per month for solo practices and $20,000 per month for practices with more than one dentist. The monthly advances will be in addition to any ongoing reimbursement payments, such as claim payments for emergency care. Total advances will be up to $20,000 for solo practices or $40,000 for practices with more than one dentist. The advances will be recovered by DDSD in twenty equal payments starting with the June 10 check run and continue through December 20, 2020. Any unrecovered payments at that time will be subject to a final settlement on December 31, 2020.

Additional details on the Reimbursement Advance Program, including how to apply and the timeline for April and May payments will be provided no later than Tuesday, March 31.

  • The DDSD Loan Assistance Program will provide up to $1 million total of interest free loans to dental practices that do not have a sufficiently strong financial position to sustain the practice and its team through the recommended COVID-19 practice restrictions.

This program will provide zero interest loans of up to $20,000 per practice, repayable by July 1, 2021, with the opportunity to have a portion of the loan forgiven for maintaining or increasing access to care for Medicaid recipients.

Additional details on the Loan Assistance Program, including program guidelines and application process, will be available by April 20, 2020, with loan distribution available in May.

Updated information will be provided to you as soon as possible in future communications by email and on this special financial support webpage.

We have had to adjust our operations because of the pandemic, and ask your patience as we develop these programs. Our contact center will not yet have additional detail to provide, but immediate questions can be emailed to financialsupport@deltadentalsd.com.

All of us at Delta Dental of South Dakota are committed to be your partners to achieve our mission of better oral health for all South Dakotans.

Sincerely,

Scott Jones
President and CEO
Delta Dental of South Dakota

Teledentistry guidance

Overview

Teledentistry is the delivery of dental care while the patient and the dentist are in different locations.

At its regular meeting on January 10, 2020, the S.D. Board of Dentistry discussed the current statutory framework pertaining to teledentistry. Current regulations, which went into effect in 2015, specifically outline that dentistry provided via teledentistry is the practice of dentistry. Licensees and registrants must meet the applicable standard of care for all dental services that are provided, including those provided via teledentistry.

In response to the impact of the COVID-19 pandemic on the practice of dentistry, Delta Dental of South Dakota (DDSD) is providing this initial guidance regarding the use of teledentistry in the delivery of limited, problem-focused examinations. DDSD expects to expand this guidance on teledentistry in the future.

Services covered

This guidance is effective beginning Monday, March 16, 2020. DDSD reserves the right to update this guidance as needed and will communicate any modifications to this guidance (e.g. addition of codes covered) by email and on our DDSD website.

DDSD will cover claims for services conducted using teledentistry for the following diagnostic services:

  • D0140: Limited oral exam

The services must be of sufficient audio and visual fidelity and clarity to be functionally equivalent to a face-to-face encounter. Reimbursement for teledentistry is equal to reimbursement for face-to-face encounters.

Billing

When reporting a service completed via teledentistry, providers are certifying the services rendered to the patient were functionally equivalent to a face-to-face encounter.

Providers should include the following codes on claims for services completed using teledentistry:

  • D9995 – Teledentistry, synchronistic; real-time encounter
  • D9996 – Teledentistry, asynchronistic; information stored and forwarded to dentist for subsequent review

These codes are reported in addition to other procedures delivered on the date of service. Fees for teledentistry are considered to be part of the service completed and will not be reimbursed separately. Fees for teledentistry codes are not billable to the patient.

As always, regardless of reimbursement, include your usual and customary charge for the code on your claim.

Documentation

DDSD will treat claims for services completed by teledentistry the same as a face-to-face encounter of the same code.

While DDSD does not require any specific teledentistry documentation, providers must document services completed by teledentistry in the same manner as those conducted in a face-to-face encounter. This includes documentation of details about the date and time, mode of service delivery, service provided, diagnoses, etc. in the patient’s clinical notes.

 

Enroll in EFT

Pandemic financial support is provided only through Electronic Funds Transfer (EFT). It's available free to Delta Dental participating dentists. Enrolling is possible by either paper or electronic form.

Questions?

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