 Provider News DentalAugust 1, 2024 August 2024 Dental Provider NewsletterAnthem wants you to be able to communicate with your Anthem dental patients clearly and accurately. We offer a free language assistance program to make this easy for you. No advance notice is required, and all languages are supported. To utilize the Anthem language assistance services, contact us toll-free, at 800-627-0004 between 8:00 a.m. and 5:00 p.m. Monday through Friday or contact us at the phone number listed on the member's identification card. When you call, please be prepared to give the representative the Anthem dental patient’s identification number for eligibility verification, and your dental practice name and tax identification number. Upon verification of eligibility, the appropriate translator will be obtained and you will be connected to the “language line” for telephonic interpretation. Please remember, in accordance with the California Language Assistance Program (CALAP), you must notify Anthem dental patients of the availability of the health plan interpreter services. You must also document a patient’s refusal of any needed interpreter services in his or her patient chart. Please refer to the Anthem Provider Manual for additional information on the Language Assistance Program, www.anthem.com/ca/provider/dental. Anthem Blue Cross is the trade name of: In California: Blue Cross of California and Blue Cross of California Partnership Plan, Inc. Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Blue Cross of California, Blue Cross of California Partnership Plan, Inc., Anthem Blue Cross Life and Health Insurance Company, and Anthem BC Health Insurance Company are independent licensees of the Blue Cross Association. In 11 northeastern counties of New York: Anthem HealthChoice Assurance, Inc. and Anthem HealthChoice HMO, Inc. In these same counties, Anthem Blue Cross Retiree Solutions is the trade name of Anthem Insurance Companies, Inc. Independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. CABC-DEN-063761-24 Please be aware, as required by the State of California, Anthem and our affiliates must follow regulated procedures that are outlined in SB137 to maintain accurate provider directories. Our responsibility is to provide accurate dental directories to our members. Anthem Blue Cross is the trade name of: In California: Blue Cross of California and Blue Cross of California Partnership Plan, Inc. Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Blue Cross of California, Blue Cross of California Partnership Plan, Inc., Anthem Blue Cross Life and Health Insurance Company, and Anthem BC Health Insurance Company are independent licensees of the Blue Cross Association. In 11 northeastern counties of New York: Anthem HealthChoice Assurance, Inc. and Anthem HealthChoice HMO, Inc. In these same counties, Anthem Blue Cross Retiree Solutions is the trade name of Anthem Insurance Companies, Inc. Independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. CABC-DEN-063758-24 We know that dental care is important during pregnancy as hormonal changes can increase the risk of dental disease. - Before providing dental care to a pregnant patient, dentists should review the patient's medical history and ask about medications or supplements being taken to identify any potential risks or contraindications.
- Consult with the patient's obstetrician (OB/GYN) to discuss any concerns or potential risks related to dental care during pregnancy. The OB/GYN can provide guidance and help determine the safest approach to dental treatment.
- Depending on the patient's stage of pregnancy and medical history, you may need to modify the approach to treatment.
- If anesthesia is needed, use the appropriate type and dosage. Local anesthesia is generally safe during pregnancy. General anesthesia should be used with caution and only when necessary.
- Pregnant women may need to be positioned differently in the dental chair to ensure their comfort and safety such as use of a pillow or wedge to support the patient's back and reduce pressure on the abdomen.
- Reinforce proper oral hygiene and encourage pregnant patients to brush twice a day, floss daily, and use an antimicrobial mouth rinse to help prevent gum disease and tooth decay.
Anthem Blue Cross is the trade name of: In California: Blue Cross of California and Blue Cross of California Partnership Plan, Inc. Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Blue Cross of California, Blue Cross of California Partnership Plan, Inc., Anthem Blue Cross Life and Health Insurance Company, and Anthem BC Health Insurance Company are independent licensees of the Blue Cross Association. In 11 northeastern counties of New York: Anthem HealthChoice Assurance, Inc. and Anthem HealthChoice HMO, Inc. In these same counties, Anthem Blue Cross Retiree Solutions is the trade name of Anthem Insurance Companies, Inc. Independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. CABC-DEN-063762-24 As a part of the Dental HMO Quality Assurance Program, your dental office has agreed to participate in the Dental Quality Assurance Program and to provide Anthem with member encounter data. The encounter data that Anthem receives from your office is utilized to monitor the level of services our network is providing our members, your patients, as well as to identify problem areas in the network. Encounter data is also utilized to provide your office additional per patient visit and procedure specific supplemental compensation according to most of the plan designs. As a reminder, there are three acceptable methods for your office to submit encounter data to Anthem: - Anthem supplied Patient Visit Record (PVR)
- ADA claim form stamped “Encounter” in red
- Automated dental practice management report
Anthem Blue Cross is the trade name of: In California: Blue Cross of California and Blue Cross of California Partnership Plan, Inc. Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Blue Cross of California, Blue Cross of California Partnership Plan, Inc., Anthem Blue Cross Life and Health Insurance Company, and Anthem BC Health Insurance Company are independent licensees of the Blue Cross Association. In 11 northeastern counties of New York: Anthem HealthChoice Assurance, Inc. and Anthem HealthChoice HMO, Inc. In these same counties, Anthem Blue Cross Retiree Solutions is the trade name of Anthem Insurance Companies, Inc. Independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. CABC-DEN-063763-24 Dental providers and facilities are required to review all member’s information to ensure no misrouted protected health information (PHI) is included. Misrouted PHI includes information about members that a provider or facility is not currently treating. PHI can be misrouted to providers and facilities by mail, fax, email, or electronic remittance. Dental providers and facilities are required to immediately destroy any misrouted PHI or safeguard the PHI for as long as it is retained. In no event are providers or facilities permitted to misuse or re-disclose misrouted PHI. If providers or facilities cannot destroy or safeguard misrouted PHI, providers and facilities must contact Customer Service or call the number listed on the documentation received to report receipt of misrouted PHI. Dental providers and facilities should review claims and documents carefully before submitting for payment to ensure that the member ID and name listed on the claim is accurate. Taking these additional steps will help eliminate explanation of benefits being sent to the wrong member and prevent HIPAA violations. Anthem Blue Cross is the trade name of: In California: Blue Cross of California and Blue Cross of California Partnership Plan, Inc. Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Blue Cross of California, Blue Cross of California Partnership Plan, Inc., Anthem Blue Cross Life and Health Insurance Company, and Anthem BC Health Insurance Company are independent licensees of the Blue Cross Association. In 11 northeastern counties of New York: Anthem HealthChoice Assurance, Inc. and Anthem HealthChoice HMO, Inc. In these same counties, Anthem Blue Cross Retiree Solutions is the trade name of Anthem Insurance Companies, Inc. Independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. CABC-DEN-063796-24 As required by the Consolidated Appropriations Act (CAA) and several state laws, we must ensure our Provider Directories are accurate. Your patients — our members — need the most up to date information to reach you. As a contracted provider, you must respond to the notification by providing updated contact information. We appreciate your due diligence in keeping us informed of any changes impacting you or your office. We are excited to announce our partnership with HealthLink Dimensions to simplify the verification process with your practice. Please be on the lookout for an email from Healthlink Dimensions which will provide steps to complete your verification of your practice. Please ensure you add Healthlink Dimensions to your trusted sender list to ensure vital communication between your office and Healthlink Dimension is received. Working together, we ensure your patients — our members — can reach you quickly while we meet our compliance obligations. Anthem Blue Cross is the trade name of: In California: Blue Cross of California and Blue Cross of California Partnership Plan, Inc. Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Blue Cross of California, Blue Cross of California Partnership Plan, Inc., Anthem Blue Cross Life and Health Insurance Company, and Anthem BC Health Insurance Company are independent licensees of the Blue Cross Association. In 11 northeastern counties of New York: Anthem HealthChoice Assurance, Inc. and Anthem HealthChoice HMO, Inc. In these same counties, Anthem Blue Cross Retiree Solutions is the trade name of Anthem Insurance Companies, Inc. Independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. CABC-DEN-063787-24 This article was updated on October 31, 2024. Welcome to Provider News, your new resource for dental communications from Anthem Blue Cross (Anthem). This platform is designed with usability in mind, providing enhanced features such as the ability to search articles by key terms and organization of articles by category. You can also print articles or save them as PDFs, to share crucial information with your colleagues. This enhancement enables us to deliver essential updates to you in a more timely manner. We're thrilled to share this upgrade with you and look forward to the continued enhancement of our communications. Consider subscribing to our emails by selecting the “Subscribe to Email” button at the top right corner of this page to ensure you receive all updates in a timely manner. View the Quick Reference Guide for more information. Anthem Blue Cross is the trade name of: In California: Blue Cross of California and Blue Cross of California Partnership Plan, Inc. Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Blue Cross of California, Blue Cross of California Partnership Plan, Inc., Anthem Blue Cross Life and Health Insurance Company, and Anthem BC Health Insurance Company are independent licensees of the Blue Cross Association. In 11 northeastern counties of New York: Anthem HealthChoice Assurance, Inc. and Anthem HealthChoice HMO, Inc. In these same counties, Anthem Blue Cross Retiree Solutions is the trade name of Anthem Insurance Companies, Inc. Independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. CABC-DEN-064492-24 ATTACHMENTS (available on web): Quick Reference Guide (pdf - 1.34mb) Tobacco use, smoking, smokeless tobacco, compressed dissolvable tobacco, cigars, pipes and water pipes, and electronic cigarettes, is a leading cause of preventable illness and death. The adverse oral effects of tobacco use include gingival recession, impaired healing, oral cancer, mucosal lesions, periodontal disease, and tooth staining. The most effective clinical modalities for treating tobacco use and dependence are counseling, medication, and both in combination. We know that dental practices can provide an effective setting for recognition (finding patients that smoke and offering information about quitting), recommending that patients quit, assess willingness to quit, help with counseling and pharmacotherapy., and arrange for follow-up contact. Cognitive behavioral therapy has been found to improve rates of cessation as do other nonpharmacological strategies (hypnosis and acupuncture). Pharmacological interventions, nicotine replacement therapy, as well as other medications (bupropion, varenicline, inhalers) have been found to be effective. To get started with a program, dental offices will want to include a question about tobacco use as part of their medical/dental history to allow identification of tobacco users and to assess a willingness to quit. And Elevance Health Care can help through the Quitting Tobacco Roadmap Program available to Elevance Health Care medical members. Other resources can be found at the websites of the American Dental Association and the Centers for Disease Control and Prevention. Anthem Blue Cross is the trade name of: In California: Blue Cross of California and Blue Cross of California Partnership Plan, Inc. Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Blue Cross of California, Blue Cross of California Partnership Plan, Inc., Anthem Blue Cross Life and Health Insurance Company, and Anthem BC Health Insurance Company are independent licensees of the Blue Cross Association. In 11 northeastern counties of New York: Anthem HealthChoice Assurance, Inc. and Anthem HealthChoice HMO, Inc. In these same counties, Anthem Blue Cross Retiree Solutions is the trade name of Anthem Insurance Companies, Inc. Independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. CABC-DEN-063788-24 Opioid pain relievers are commonly prescribed following surgery or injury, or for health conditions such as cancer. They may also be prescribed for moderate to severe acute dental pain.1 While opioids can be effective for managing chronic pain and other conditions when properly administered, they carry significant risk when misused or abused. Regular monitoring and identification of early risk factors is critical to recognizing patients who are most at-risk for prescription drug abuse issues and those who need treatment. Commitment across the healthcare industry is needed to effectively fight prescription opioid abuse. What dentists can do As dentists, you have a significant role in ensuring appropriate prescription opioid use. To understand your role, you should be familiar with these two statements from the American Dental Association addressing opioid prescribing: Statement on the Use of Opioids in the Treatment of Dental Pain2, and Statement on Provision of Dental Treatment for Patients with Substance Use Disorders3. These statements outline opioid management considerations including the importance of: - Registering with and utilizing prescription drug monitoring program.
- Discussions with patients regarding their responsibilities for preventing misuse, abuse, storage and disposal of prescription opioids.
- Using non-steroidal anti-inflammatory analgesics as the first-line therapy for acute pain management.
- Coordination with other treating doctors, including pain specialists when prescribing opioids for management of chronic orofacial pain.
- Consulting with the patient's physician when the patient has a history of alcoholism or other substance use disorder.
The Centers for Disease Control and Prevention (CDC) notes that Prescription Drug Monitoring Programs (PDMPs) are among the most promising interventions to improve opioid prescribing, inform clinical practice, and protect patients at risk.4 - Enroll in your local PDMP.
- A PDMP allows providers to identify situations in which they should not be prescribing a controlled substance to a patient. This enables dentists to move towards better medication adherence and helps to curb the prescription drug abuse epidemic.
- American Dental Association. Oral Analgesics for Acute Dental Pain. Available at https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/oral-analgesics-for-acute-dental-pain (Accessed May 2023).
- American Dental Association. Statement on the Use of Opioids in the Treatment of Dental Pain. Available at https://www.ada.org/about/governance/current-policies (Accessed May 2023).
- American Dental Association. Statement on Provision of Dental Treatment for Patients with Substance Use Disorders. Available at https://www.ada.org/about/governance/current-policies#substanceusedisorders (Accessed May 2023).
- Centers for Disease Control and Prevention. Prescription Drug Monitoring Programs (PDMPs); What Clinicians Need to Know, Available at https://www.cdc.gov/overdose-prevention/hcp/clinical-guidance/prescription-drug-monitoring-programs.html (Accessed May 2023).
Anthem Blue Cross is the trade name of: In California: Blue Cross of California and Blue Cross of California Partnership Plan, Inc. Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Blue Cross of California, Blue Cross of California Partnership Plan, Inc., Anthem Blue Cross Life and Health Insurance Company, and Anthem BC Health Insurance Company are independent licensees of the Blue Cross Association. In 11 northeastern counties of New York: Anthem HealthChoice Assurance, Inc. and Anthem HealthChoice HMO, Inc. In these same counties, Anthem Blue Cross Retiree Solutions is the trade name of Anthem Insurance Companies, Inc. Independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. CABC-DEN-063793-24 |