The Advantage Newsletter September 2015

THE ADVANTAGEThe Advantage Community Newsletter

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INSIDE THIS ISSUE:From Where I SitOHP Provider NewsCommercial Provider NewsAdvantage NewsASK NewsMember BenefitsEvents & Helpful Hints for HRSummer Meeting Details

OUR MISSIONTo provide dental leadership, service and access to care for our communities in a professional, entrepreneurial and sustainable manner.

WIN A KINDLE!Thank you to EVERYONE who participated in the Advantage Dental Newsletter Kindle Drawing.

Nikki Kirkland with Jones Family Dental won last quarter’s Kindle. Be sure to enter for your chance to WIN this quarter’s Kindle by emailing [email protected].

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From Where I SitBY TOM TUCKER, DMD, CEOADVANTAGE DENTAL

I have been here at Advantage for over eight months and I am still surprised by the scope and complexity of the Advantage Organization. Each day, I gain a greater appreciation for the contributions that everyone, contracted or employed by Advantage, must make to insure the delivery of quality dental care to so many fellow Oregonians. From a maximum of 345,000 individuals, to now, a slight reduction due to redetermination, to approximately 336,000, we are still the largest DCO and the only one contracted with all sixteen CCOs. Without everyone’s willingness to step up and take more patients combined with many extra hours and additional work from clinic and administrative support staff, we could not have managed this unprecedented growth.

I would like to thank all of you who attended the Advantage Summer Meeting, for contributing to its great success. We more than doubled our

attendance of last year, and raised over $79,000 for ASK. This could not happen without such a huge team effort from our dedicated Advantage staff. We received so many positive comments about the quality of the classes, the excellent meals that were provided and the overall value for the cost of attendance. We were so successful that as we have begun to plan for next year’s meeting, we are exploring ways to accommodate even more attendees. As we develop the program for next summer’s event, you will see even more offerings. We are considering a Golf Scramble, to provide an additional reason for attending an already high quality educational event. Be sure to save the date on your calendars for the last weekend in July for next year’s summer meeting.

With our growth and greater collaboration with CCOs and the Oregon Health Authority, new and often times burdensome regulations and requirements, have been imposed on Advantage and its OHP providers. This has required the re-credentialing of all providers; owner Dentists, Primary Care Dentists, Specialists, on call Dentists, and associates of any OHP contracted provider. I know this is not a short, easy process, and for those of you that have it completed already, thank you for your perseverance. Understand that this is a requirement imposed on Advantage by the agencies we are contracted with. Please take the time to comply with this process and thank you for doing it in a timely manner.

As summer begins to wane, we are hopeful that fall rains will bring an end to the devastating wildfires, and winter will produce much more snow in the mountains than the last year or two. Know that I appreciate the services that you provide to Advantage and the patients we serve. Every day we offer the opportunity for our patients to improve their health and wellness and make this available to a segment of our population that has not always had the ability to receive these services. Again, thank you and know that your dedication and effort is sincerely appreciated.

Respectfully, Tom

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Compliance News

Claims Submission and the NPIBy Jeff Dover, Compliance ManagerOther than prior authorizations, billing and claims submission are, to put it gently, the bane of the practitioner’s practice. The clinician’s time, money, and employee hours spent on the three can easily overwhelm a practice. This is an oversimplified explanation of payment methods and why proper claims submission is required.

The two main types of reimbursement are fee for service and capitated payments. Capitated payments can seemingly relieve the burden of billing and submitting claims, but in reality offer little relief. For example, if a provider is reimbursed in a capitated system, the provider

will receive a set amount of money Per Member Per Month (PMPM) to provide a set of services to the patients potentially with carve-outs for expensive or difficult procedures regardless of how many patients the provider sees or how many procedures are performed. Though the capitated system may streamline billing, many payors still require the providers to submit claims for encounter data purposes.

Encounter data is information showing use of provider services by health plan enrollees that is used to develop cost profiles of a particular group of enrollees. The profiles are then used to guide decisions about or provide justification for the maintenance or adjustment of premiums. (Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier). This is particularly useful in Medicare Advantage and CCO Medicaid plans as we have in the State of Oregon. Similarly, in the commercial lines of business, mental health, alternative medicine, and other non-medical/surgical benefits are administered on a capitated basis, thus encounter data derived from claims is often collected by the insurer.

Regardless of whether a provider is part of a capitated system or a fee for service system, the claims data that is sub-mitted must be accurate and submitted correctly. A common point of contention and common source of errors is the correct use of the National Provider Identifier (NPI). Specifically, the provider that actually renders the service is left off the claims form or the NPI of a different provider is submitted as the rendering provider.

In the realm of billing for dental services, the 2012 ADA Dental Claim Form is used. Specifically, for box 54 “NPI”, the actual treat-ing dentist must have their NPI filled in. Additionally, box 49 “NPI” under Billing Dentist or Dental Entity must be filled in with the entity’s Type 2 NPI. If the billing provider is a solo practitioner, then box must be filled in with the rendering provider’s NPI from box 54.

You may be asking yourself why having the actual rendering provider’s NPI on the claims form is important. Additionally, how does this apply to a provider that doesn’t bill Medicare or a Medicare Advantage Organization? The answer is three-fold. First, the reimbursement rate may be lower, higher, or the procedure may not be billed based upon the provider that rendered the service. This is a Fraud, Waste, and Abuse issue. Second, including the correct NPI allows the insurer, payor, CMS, CCO, or other responsible organization to insure that the provider is not excluded from participation in a Medicare or Medicaid plan, or from receiving federal dollars. Third, many of the insurers and payors that providers submit claims to follow this methodology.

Providing the correct NPI number on the front end of the claim submission process can save providers and payors an ex-traordinary amount of resources should an audit occur, the prospect of having to return funds or adjust claims if improper billing is found, and following this methodology will likely keep a provider in compliance with all of their contracts with insurers and payors. If you have any topics you would like to see addressed or have any questions, please contact me at 541-504-3961 or at [email protected].

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Newly Contracted Providers

Jeb Anrus, DMD Eugene, OR

Parisa Ansari, DMD Eugene, OR

Cade Baldwin, DDS Blackfoot, ID

Turrell Beck, DDS Kennewick, WA

Eric Berkner, DMD The Dalles, OR

Brian Bollwitt, DMD Salem, OR

Nathan Bourassa, DDS Coeur d’Alene, ID

David Case, DDS Portland, OR

Richard Davenport, DMD Aurora, OR

Edward Dolan, DDS Pendleton, OR

Ramsey Edwards, DMD La Grande, OR

Clark Elkins, DMD Emmett, ID

Lisa Gitelson, DMD Tigard, OR

Daniel Harper, DMD Salem, OR

Daniel Harper, DMD Roseburg, OR

Daniel Harper, DMD Eugene, OR

Bradley Hobson, DDS Lewiston, ID

Erina Hung, DMD Eugene, OR

Please welcome the newest providers to the Advantage Dental Community (April 2015 - July 2016)

W E LCO M E !

Rupinder Johl, DMD Bend, OR

Brian Kitchell, DMD Ashland, OR

John Malan, DDS Nampa, ID

Veronica Montgomery, DDS Boise, ID

Joshua Myers, DDS Winston, OR

John Ritacca, DDS Bend, OR

John Ritacca, DDS Gold Beach, OR

Anthony Royal, DMD Roseburg, OR

Ryan Toponce, DMD Kennewick, WA

Rufus Van Dyke III, DDS Pocatello, ID

Anastacia Whitman, DMD Portland, OR

David L. Wilson, DMD Tigard, OR

Robert Wood, DDS Tigard, OR

Peter Yonan, DDS Bend, OR

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Oregon Health Plan (Medicaid) Provider News

2015 Utilization and Withhold: Doubling and Tripling Withhold

The QI/UR Committee has decided to implement a policy the Company has had in place for several years. That is, we will be doubling or tripling withhold reductions from capitation for providers that are too far out of line on the CAPGr vs ENC and those that are over on both CAPGr vs ENC and Ref vs Cap. Below are the criteria for doubling and tripling the withhold. NOTE: The Company will continue to double or triple your withhold reduction from your capitation until you are back in line with the goals of the Company listed above.

Primary Care Dentists with LESS THAN 250 assigned members will not be subject to doubling and tripling of the withhold.

CAPGr vs ENC is over 125% = Doubled WithholdCAPGr vs ENC is over 150% = Tripled WithholdCAPGr vs ENC is over 100% & Ref vs Cap is over 35% (45% for self-referring dentists)= Doubled WithholdCAPGr vs ENC is over 100% & Ref vs Cap is over 60% (70% for self-referring dentists)= Tripled Withhold

The doubling and tripling of withhold began with the August capitation paid in September.

If you feel that you or your office staff needs training on the Utilization Report and how it works, please feel free to contact Provider Relations at the contact information listed below to set up training.

If you have questions regarding this, please let us know by calling the Provider Only Line at 888-480-4478 or email [email protected].

Changes to Phone system

The next time you call the Advantage Dental Provider Only Line (888-480-4478), you may notice some changes. You will now be given options to choose the reason you are calling from a phone tree. This tree will route you to a specialist in that field! You will be given the following options:

For OHP member eligibility or questions about an OHP member, press 1For Claims or Explanations of Benefits Questions, Press 2 For Questions regarding a Preauthorization or Referral that has been entered, Press 3 For credentialing, contracting, or training, Press 4 For all other calls, Press 5

Thank you for your continued patience with Customer Service as Advantage Dental continues to grow and expand its staffing.

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Health Care For the FutureBetter Health • Better Access • Better Value

CHANGES YOU SHOULD BE AWARE OF

Changes to ohP assignment

Due to the Medicaid expansion taking place in 2014, Advantage OHP continues to grow throughout Oregon. So, in an effort to better serve the patients, as well as Advantage’s State and CCO Contracts, plus meet the needs of all of the dentists in the regions; some reassignments continue to take place.

You will see some reassignments of patients and some of you will be reopened to take additional assignment of patients in your designated region. As these reassignments happen, we attempt to notify all PCDs that are affected at least 30 days in advance. All patients have the right to stay with the provider they are currently with; providers can keep patients in transition, as well as any patients currently in treatment. So, if you have a patient in treatment or other patients you wish to keep that do somehow get reassigned, please let Advantage Customer Service know right away at 888-480-4478 Option 1 and they will correct this immediately.

all advantage dental serviCes mediCaid Providers:Reminder! Updated OHP Provider Application and Agreements were due June 2015.

As many of you are well aware, in this new world of coordinated care organizations, many policies and processes within Advantage Dental are changing. Due to the increased regulations that are being placed on the CCOs, and in-turn their delegates; (Advantage Dental,) the provider credentialing policies within the company are being revised to be in compliance with these new requirements.

In April a memo was sent to every provider that is contracted to see OHP patients, requesting that they complete the new online application form and return a signed OHP Provider Agreement by June 1, 2015. This included, but was not limited to Owner dentists, Primary Care Dentists, Specialists, On-Call Providers, and Associates of any OHP Contracted Provider. The new application mirrors the Oregon Practitioner Credentialing Application. One of the benefits of this application is that you will be able to print it out and use it to recredential with other insurance companies like ODS and Regence.

At this point, about 65% of contracted providers have completed both the online application and returned the signed contracts. Please complete this as soon as possible so that Advantage Dental can stay in compliance and we can all continue to serve the less fortunate in our communities.

Please go to www.AdvantageDental.com and click on “Become a Provider” to complete the new application. If you need help with this process please contact Provider Relations at: [email protected]. If you have questions on completing the online application please contact Provider Relations at 888-480-4478 Option 4 or [email protected].

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COMPANY MEMO REGARDING OHP CHANGES


August 25, 2015

TO: Advantage Dental Services, LLC, Primary Care Dentists (PCDs)

FROM: Thomas Tucker, DMD, CEO

RE: Change in Billing for Silver Fluoride

As you are all aware, Silver Fluoride has been approved by the FDA. The recently approved CDT code for silver diamine fluoride (D1354: interim caries arresting medicament application) will not be active and cannot be used until 2016.

Advantage Dental has asked all PCDs to use the code D9910 (application of desensitizing medicament) plus D1206 (application of fluoride varnish) to document and track use of silver nitrate. Now that silver diamine fluoride (Advantage Arrest) is an approved form of treatment, the D1206 code does not correctly describe the procedure. Instead, PCDs will need to start using D1208 (topical application of fluoride) plus D9910 as an interim method to document and track use of silver diamine fluoride. Beginning January 1, 2016, PCDs should switch to D1354 (interim caries arresting medicament application) as the correct code to doc-ument and track use of silver diamine fluoride.

If you have any questions regarding the use of silver diamine fluoride (Advantage Arrest) please feel free to contact Advantage Dentals Dental Director, Dr. Gary Allen, at 541-504-3938 or by email to [email protected].

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Commercial Provider News

One in 4 People Prescribed Opioids Progressed to Longer-Term Prescriptions July 1, 2015 - Mayo Clinic publication

ROCHESTER, Minn. — Opioid painkiller addiction and accidental overdoses have become far too common across the United States. To try to identify who is most at risk, Mayo Clinic researchers studied how many patients prescribed an opioid painkiller for the first time progressed to long-term prescriptions. The answer: 1 in 4. People with histories of tobacco use and substance abuse were likeliest to use opioid painkillers long-term. The findings are published in the July issue of the medical journal Mayo Clinic Proceedings.

While the study identified past or present nicotine use and substance abuse as top risk factors for long-term use of opioids, all patients should proceed with caution when offered opioid painkiller prescriptions, says lead author W. Michael Hooten, M.D., an anesthesiologist at Mayo Clinic in Rochester.

“From a patient perspective, it is important to recognize the potential risks associated with these medications. I encourage use of alternative methods to manage pain, including non-opioid analgesics or other non-medication approaches,” Dr. Hooten says. “That reduces or even eliminates the risk of these medications transitioning to another problem that was never intended.”

Discovering who is likeliest to end up using the drugs long-term is critically important due to the widespread problems associated with their misuse, he says.

“Many people will suggest it’s actually a national epidemic. More people now are experiencing fatal overdoses related to opioid use than compared to heroin and cocaine combined,” Dr. Hooten says, citing data from the Centers for Disease Control and Prevention.

Researchers used the National Institutes of Health-funded Rochester Epidemiology Project to get a random sample of 293 patients who received a new prescription in 2009 for an opioid painkiller such as oxycodone, morphine, hydromorphone, oxymorphone, hydrocodone, fentanyl, meperidine, codeine and methadone.

They found that 21 percent, or 61 people, progressed from short-term use to prescriptions lasting three to four months, and 6 percent, or 19, of the 293 studied ended up with more than a four-month supply of the drugs.

The identification of nicotine use and substance abuse as top risk factors for long-term use of opioids suggests that physicians should be particularly careful about prescribing the painkillers to patients with such histories, Dr. Hooten says.

Why is there such a connection? The science shows it’s all in our heads. The neurobiology related to chronic pain, chronic opioid use and addiction is similar, Dr. Hooten says. For example, nicotine activates a group of receptors, or brain structures, in a way very similar to how opioids and chronic pain may activate them.Long-term opioid use may actually make people more sensitive to pain – a condition called opioid-induced hyperalgesia, another recently published study by Dr. Hooten and other Mayo researchers found.

If opioids must be used, as is usually the case with surgery or traumatic injuries, reducing the dose and limiting the duration is important, Dr. Hooten says.

“The next step in this research is to drill down and find more detailed information about the potential role of dose and quantity of medication prescribed,” he says. “It is possible that higher dose or greater quantities of the drug with each prescription are important predictors of longer-term use.”

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What is the Limited Network Plan with PacificSource?PacificSource’s limited network plan is a DHMO prod-uct designed to limit the choice of providers a mem-ber can go to. Providers are paid on a capitated basis and not fee for service. This plan will not be a fit for all provider offices to participate in.

The reimbursement received will be lower than the cost of services rendered. If you have more questions about this plan please contact Advantage at:

[email protected]

PacificSource Company StatsYTD Average through June 2015:

Dental Claims turnaround: 9 days

Dental Claims Auto-Adjudication 79%

Dental Average Speed to Answer: 23 seconds

Dental Call Abandonment Rate: 2%

Percentage of Dental Calls answered within 30 seconds: 84%

Commercial Provider News

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Fax: (541) 677-7601

963 SW Simpson Ave, Suite 130 • Bend, Oregon 97702www.e-coriant.com / 541.306.4842 / 866.479.9070

Contact Associates:Gale Slaughter / Account Manager / [email protected]

Lesley Truman-Webb /Creative Services Manager / [email protected]

Appointment Cards � Business Cards � Reminder CardsDirect Mail � Postcards � Brochures � Stationary � Folders

Statements � Return/Outgoing Envelopes � Business Documents � Filing ProductsHIPPA Compliant Forms � Prescription Pads � Custom Specialty Items

Document Imaging and Mailing

Promotional Give-Aways:Toothbrushes � Floss � Toothpaste

Bags � Toothbrushing Timers � Cold/Heat PacksDental Care Coloring/Activity Books � Stress Toys � And Much More!

Professional, Active and Outerwear

Print | Marketing | Creative Services

PacificSource Information:PacificSource’s web page dedicated to dental providers contains easy to find information you need to do business with them. Visit PacificSource.com/DentalProviders to find commonly needed information conveniently located in one place:

• Claims guidelines• Practice guidelines• Preauthorization information• Administrative forms• Dental Bulletin newsletters• And more

Convenient, Fast ServicePacificSource has a dedicated phone line for their Dental Customer Service team. Next time you have a question about dental benefits or claims, contact them at:

Local (Eugene): (541) 225-1981

Toll-free: (866) 373-7053

Email: [email protected]

PacificSource Dental GrowthPacificSource has sold 12 large group dental groups since January 2015. Ten of these groups are in OR and two are in ID. Six of these were groups that added dental to current medical-only policies. The smallest group has 118 employees and the average group size is about 700 members.

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Advantage News

Congratulations to Kindle Winners• Dr. Marilyn Switzer• Dr. Denise Hicks• Brenna SouthwickThank you for visiting the vendor booths!

Dentists

Hygienests

Dental Assistants

Office Staff

Vendors

2015 Summer MeetingAnother year down, another Advantage Summer Meeting in the books. This year there was record attendance at this annual event:

122 Dentists50 Hygienists

40 Dental Assistants38 Other Office Staff

12 Vendors

This is an 87% GROWTH over the 2014 meeting!

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Advantage News

ADVANTAGE DENTAL REPORTING HOTLINEAdvantage Dental is committed to maintaining high integrity. If you are aware of incidents, issues, or concerns regarding the organization, please consider reporting them to management. Anonymous and confidential reports can be submitted using our independent third-party anonymous and confidential reporting service.

You will need to reference our Company ID when reporting incidents or concerns: ADVANTAGE

Reports can be submitted at www.FRAUDHL.com 24-hours a day using the secure online reporting form or by calling or faxing to the toll-free number 1-855-FRAUD-HL

The open house event was very successful.

Dr. Shirtcliff has been on the road, meeting with legislators and dentists, as Advantage Dental prepares for the Idaho Department of Health and Welfare to release its Request For Proposal for the Medicaid dental program. The main theme during his discussions was the importance of managed care for good oral health. Advantage will be bidding on the Idaho Medicaid contract and should know by January 2016 if it is awarded the contract.

Advantage Dental Has a New Office In Idaho!Advantage opened a new administrative office in Boise in July. The

office is located in the Historic Hoff Building at:

802 W. Bannock St. Suite LP 107

Boise, ID 83702

Advantage Dental in Idaho

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Advantage Smiles for Kids Update

Caring Professionals Providing Orthodontics for At-RiskYouth Throughout Oregon

ASK Facts:• ASK has provided braces for more than 400 kids • ASK kids perform 1000+ hours of community service each month• ASK partners with 56 orthodontists throughout Oregon• All approved applicants are required to have grades in good standing

Baylee, sponsored by Cecilee & Bruce ShullA difficult home life and bullying due to the look of Baylee’s teeth have been affecting her self-esteem, school attendance, and grades. “People called me names and said that I’m pretty until I open my mouth.”

She is now involved in a youth mentorship program, her grades have come up, and she is very grateful to have braces.

Zack is being sponsored by Advantage Dental EmployeesZack has flourished with his volunteer work, helping at local pet adoption events, doing church outreach, and helping elderly neighbors with yard work. Zack wrote a thank you letter which read, “Thank you for giving me this opportunity for straight teeth. My foster family and I are very grateful for this to happen to me.”

Zack is being treated by Dr. Ravassipour in Medford.

before braces

Please welcome Dr. Rachel Yamakawa, of Smile Keepers in Milwaukie and Keizer, Oregon as the newest ASK partnering orthodontist.

Baylee volunteers at the local food bank and isbeing treated by Dr. LeMert in Coos Bay.

before braces

13ASK is a non-profit 501 (3)(c) organization

Advantage Smiles for Kids Update

2015 Advantage Smiles for Kids Raffle & Auction at Eagle Crest Resort

New to the silent auction this year was artwork donated by ASK kids. Dr. Thomas Tucker, CEO of Advantage Dental, purchased the art for display in Advantage Dental clinics throughout Oregon.

Left: Dr. Thomas TuckerCongratulations to all of our Raffle Winners!Dr. Vincent Quas – Explore Key WestDr. Thomas Tucker - Napa Valley AdventureJanice Taylor – Charleston Luxury Getaway

ASK Board: Dr. Mike Shirtcliff, Don Laird, Dr. Kyle House, Dr. Benita Wong, Boni Smith, Brenda Turner, Dr. Juliana Panchura, Linda Dwight, Cindy Shirtcliff, Dr. Rob Orr and some of our great ASK Kids: Isaiah, Kaitlyn, Chase, Morgan

To learn more about becoming a Donor Member or to sponsor a

child for orthodontic treatment in your community contact Michael

Vendrame at: [email protected]

or by phone at (541) 504-3912.

THANK YOU to those who generously gave to ASK and made it possible to exceed all expectations

with over $79,000 raised!

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BY R. MIKE SHIRTCLIFF, DMD, PRESIDENT AND FOUNDER

Sitting in my current position is interesting and at times I don’t know what to do for sure. I know this is unlike me, but it is the truth. Advantage has grown under my tutelage to a $100 million company that is returning significant money back to its owners. One has to take this into context for there were times this was not so. In most cases excess money was put back into the company to keep up with growth opportunities.

My philosophy has always been to do the right thing by everyone including patients, doctors, staff members , owners, communities etc. and the money would follow; doing good, making some money, and having some fun or healthy, wealthy and happy, so to speak. The issues that come up each day are just problems to solve to get there rather than obstacles that frustrate us and keep us from moving forward.

A big part of what I wanted to do was create a system that provided access to adequate dental care to all citizens of Oregon in spite of their economic situation, while we work on a system of population-based prevention model that eliminates the ravages of the caries process. The surgical/restorative paradigm that organized dentistry uses works well for those that have the means and the behaviors needed to put it to use. It does not work well in populations like Medicaid, where most do not have the means, their disease is out of control and they do not have the behaviors needed to use this paradigm. I liken it to polio; the ravages of the disease were treated with iron lungs and leg braces. Eventually the cause for polio was found, a cure was found and the need for these treatments was eliminated.

Cavities are the result of a multifactorial bacterial infection fed by excessive refined carbohydrates. The cavity and hole in the tooth is the result of this infection. The treatment for this disease is not a filling. The treatment for this disease is to get the infection under control. This can be done with altered nutrition, mechanical debridement and antimicrobials among other things. Someone who gets cavities is considered moderate to high risk. Those that fall into these categories should have the infection brought under control before or while the restorations are being done. The quickest way is with antimicrobials such as silver compounds in conjunction with fluoride. When the cavity on dentin is sterilized and fluoride is added, the tooth combines the fluoride with calcium from the saliva and then the tooth re-mineralizes the cavity and makes it hard. It also turns the cavity black which, with the hardness, is the indication that the caries process is arrested. There is indication that 90% of the silver is absorbed by the tooth and this keeps the bacterial biofilm from forming in the tooth, resulting in less overall tooth decay. Time should go by – 6 months to a year – to make sure no new decay develops. Then restorations can be done if indicated. Sometimes when aesthetics is an issue the fillings need to be done sooner.

Low risk patients with no decay or gum disease should be encouraged to brush twice a day for two minutes with fluoride toothpaste and seen once a year to see if their risk status has changed. I believe that we have the tools to get the disease under control without the patient’s compliance. We can do this by taking the science to the people rather than waiting for people to show up in our offices with a problem. By doing screenings in various locations, risk assessments, preventative events in the community, having an electronic system that allows us to read the information in a way so that everyone has access to the information including the dentist and case managers, the patients with problems can be helped to obtain the appropriate access they need in an appropriate setting.

Advantage has several programs where this is being done, WIC programs, drug and alcohol treatment programs, Head Start, school based health centers etc. Expanded function hygienists are used to do the screenings coupled with a dental home and centralized case management. Patients are screened for risk, level of care needed being: 1) nothing observable, 2) observing issues but nothing emergent or urgent and 3) having urgent or emergent issues. Those with urgent or emergent issues are the highest priority.

Over time this should reduce the amount of ravages or the disease, save money, free up chair time and free up money from unnecessary disease for those already suffering from the ravages of the disease. I hope this gives you a good picture of what is going on with Advantage and its care for over 330,000 Medicaid patients.

I suspect as time goes on medical insurance will include oral health preventive strategies and dental insurance will cover less and less complicated restorative procedures. There are plenty of studies that show that patients with good oral health have better health outcomes. 100% of the patients need to be seen at least once a year and if they have periodontal disease and caries these infections need to be eliminated. They should also be checked for other pathologies such as abscessed teeth, large carious lesions, oral cancer, diabetes, high blood pressure, addictions, etc. and then treated and/or referred. These are the things that help overall health, rather than complex restorative procedures. Updating patient’s existing restorations to more aesthetic restorations eats up the maximum allowable and preventing patients from getting their preventive treatments done. I suspect plans will be sold with bifurcated benefits of some sort that allow the preventive regular checks to not be crowded out by optional restorative procedures. It could be that the medical plans sell the preventive plans in their medical plans and the restorative plans become riders.

One thing I have learned that surprised me over time was how oral health issues influence the overall spend of the health care dollars in the community; Kids and others in the hospital OR, adults and children in the hospital ED, medications written for dental infections and pain etc. Think about how dentistry would be if there were no dental phobics or children and disabled folks needing to be treated in the hospital.

Anyway, I have been working hard on strategies for the future, looking to advise the Board of Consolidated on where dentistry is headed and strategies to get there, all the while trying to preserve our way of life as dentists and having some control over our profession going into the future; and getting to the table to have some say in what is happening to the oral health care profession.

Thanks for all you do and thanks for your support over the years.

Advantage Dental Vision & Strategy

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Member Benefits

TECHNICAL SERVICESComputer Habits Computer Habits offers Advantage Dental members a 10% discount off of their

hourly rate for I.T. Services.

Lan Tel Lan Tel Services provides reliable custom solutions to your communication needs, including IP phones, data cabling, telephone systems, voicemail systems, satellite office support and networking remote offices for seamless, transparent office communication.

CDW Receive corporate discounts on your I.T. hardware/software needs through CDW. This offer applies to staff and family as well as dental offices.

Continu Continu offers a 20% discount on all annual contracts.

Trend Micro Through the Advantage program, you will receive Trend consumer software products at 50% MSRP. This will be triggered by the promo code that will be sent to you when you click the sign up button on the Advantage Dental website (www.advantagedental.com). This offer is valid for new sales only.

Tesia Advantage Dental providers receive three months of FREE unlimited claims submission (including paper claims printed and mailed). After that, you will only pay $39.95 per month for unlimited claims submissions.

Local Fresh Local Fresh offers Advantage Dental members a 10% discount on published 2015 rate sheets, including any ongoing marketing services to help promote the practice online.

PROFESSIONAL SERVICESPhysician's Resource Physician’s Resource offers a complimentary OSHA Compliance Evaluation

of your facility to determine your practice needs. As a network provider with Advantage Dental you will enjoy a discounted fee-for-services provided by Physician’s Resource.

Advantage Credit Services

Advantage Credit Services manages accounts receivable, helps the practice to provide patient financing and offers assistance for the front office team.

EnviroShred NW EnviroShred NW is AAA certified by the National Association for Information Destruction (NAID), the highest certification in the industry for secure destruction.

DON’T FORGET TO TAKE ADVANTAGE OF THE MEMBER BENEFITS AVAILABLE TO YOU!

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Member Benefits

DENTAL SUPPLIERSHenry Schein Advantage Dental members can save up to 10% on dental supplies and 15% on

equipment purchases through Henry Schein.

Patterson Dental Patterson Dental offers Advantage Dental Members a no-obligation complimentary upgrade in the Patterson Advantage program. Silver Level customers are upgraded to Gold Level, Gold Level customers are upgraded to Platinum Level and Platinum Level customers are upgraded to Diamond Level.

Dentsply Tulsa Dental Dentsply offers a 15–30% discount on Tulsa Dental rotary systems, and a 30% discount on Tulsa products (if you are an Endodontist your direct program with Tulsa will likely have greater savings than those offered to general dentists through this program).

Crest/Oral B Advantage Dental providers receive a significant discount on Brush/Paste/Floss/Bag Bundles. You must order using the Advantage group number (this number can be obtained from an Advantage Dental representative once you are contracted).

Byotrol (Integrated Resources International) Byotrol offers a 10% discount to all Advantage Dental providers.

PROFESSIONAL SERVICESCoriant Workflow Solutions

Receive 2-8% savings on print, marketing, branding and print-to-mail solutions when using Coriant.

Creative Lighting Solutions

Creative Lighting Solutions is able to design an “organic lighting solution” that puts the lights where the customer needs them most to perform daily job functions and highlight dental office environments. Advantage Dental Group Members receive a 25% discount on lighting retrofits.

Pacific Continental Bank

As an Advantage Dental exclusive banking client, you’ll benefit from a complimentary checking account, online bill pay services, preferential depository rates, and access to our highly competitive consumer lending rates.

Watkinson Laird Rubenstein Baldwin & Burgess, P.C.

Advantage Dental providers receive a 10% discount on flat fee services such as formation of spouse-owned entities, employee handbooks, and flexible benefit plans. WLRBB has offices in Portland, Eugene, Roseburg, and Grants Pass.

Unum Advantage Dental providers that have interest in ownership are eligible for a group disability policy through Unum at a very reasonable premium.

D.A. Davidson & Co. Special fee arrangements are provided for Advantage Dental Members through Duncan and Associates, consultants with D.A. Davidson & Co. Member SIPC.

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Upcoming Events

SAVE THE DATECENTRAL OREGON & GORGESUMMIT TO REDUCE RX ABUSE

WEDNESDAY, OCTOBER 14, 20158:30 a.m. - 4:30 p.m. Deschutes County Fairgrounds | Redmond, OR

Prescription drug abuse and misuse kills more Oregonians than any illegal drug.Deschutes County, the Central Oregon Health Council (COHC), PacificSource Community Solutions, the Governor's Office, the Oregon Health Authority (OHA), and the Oregon Coalition for Responsible Use of Meds (a service of Lines for Life) are sponsoring a summit to develop a Central Oregon & Gorge Action Plan to reduce abuse, misuse, and overdose of prescription drugs.The Oregon Coalition for the Responsible Use of Meds (OrCRM), a statewide task force formed to implement the Governor's plan to reduce Rx abuse, is hosting this event.The summit will bring together representatives from the medical community, pharmacies, health care systems, treatment providers, educators, law enforcement, public health, prevention organizations and others to:• Identify challenges and solutions to reducing prescription drug abuse, misuse, and overdose, including those unique to Central Oregon & the Gorge • Draft regional Action Plans to reduce prescription drug abuse, misuse and overdose

Please join us for this event! For more information about this event visit www.orcrm.org or contact Elizabeth White at Lines for Life: [email protected].

www.orcrm.org

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Upcoming Events

Please contact Michelle at 541-504-3958 or email [email protected] for more details and/or to RSVP.

DATES & DESTINATION:October 8th from 6pm to 9pm in Salem at the Grand Hotel 201 Liberty St SE, Salem, OR 97301 - The Marion Room Dinner will be servedOctober 22nd from 6:00pm to 9:00pm in Wilsonville at the ODA building 8699 SW Sun Place, Wilsonville, OR 97070 Dinner will be servedOctober 23rd from 9am to 12pm in Tigard at the Embassy suites at Washington Square 9000 SW Washington Square Rd, Tigard, OR 97223 Breakfast will be served

Medical Management of CariesReceive 3 Hours of Free CE

Instructors: Gary Allen, DMD, MS & Sharity Ludwig, RDH, EPP

FREE CONTINUING EDUCATION OPPORTUNITIES

Did you know you can medically manage cavities? Come learn how to stop the infection and treat decay without a needle!

SEATING IS LIMITED! SIGN-UP NOW TO GUARANTEE YOUR SPOT!

GIVEAWAY:3 Bottles of Advantage

Arrest will be given away at each event.

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Upcoming Events

Oral Health in the New Age of Aging Perspectives on Epigenetics, Gerontology, and Chronic Diseases

Geriatric Oral Health is in a State of Decay! Senior population growth is skyrocketing, and estimates are it will double from

about 40 million to 80 million in the next 35 years. 75% of health care costs are spent on chronic disease ($1.5 trillion each year). Only 9.8 % of seniors retire with dental benefits – painfully low! 23% of older adults have not had a dental visit in the last 5 years.

This conference will deal with the tough questions about disparity of care among the elderly and those who suffer from chronic disease. This is a grown up discussion about a grown up population that is entering into a new age of uncertainty.

Conference presenters: Lisa Sardinia, PhD, Pacific University – Understanding epigenetics / nature & nurture Mary Northridge, PhD, NYU – Promoting oral health equity for older adults Michael Glick, DMD, Professor, Researcher – Attacking chronic disease from all fronts Expert panel: Pat Berry, PhD, RN – Director of Hartford Center of Gerontological Nursing Excellence Bruce Gutelius, MD, MPH – OHA Public Health, Chief Science Officer John Tapogna, BA, MPP – President, ECONorthwest Visit www.orohc.org now for Conference registration!

10th Annual Fall Conference October 2, 2015

8:00am check-in 9:00am – 3:30pm Program

Meals included

Pre-Event Workshops October 1, 2015 1:00 – 4:30pm

Local Oral Health Coalitions Workshop First Tooth Trainer Workshop

Crowne Plaza Hotel

1441 NE 2nd Avenue Portland, OR 97232

Advantage Dental442 SW Umatilla Ave. Suite 200Redmond, OR 97756

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antage

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Would You Like More Information Regarding Member Benefits?

WIN A KINDLEEmail the Advantage Marketing Department to be entered into the drawing for a Kindle reader. Simply email:

[email protected] let us know if you have any questions about information contained in this newsletter, or if you would like more information about any of the member benefits programs. ENTRY DEADLINE 12/11/2015

W I N !

The Advantage Newsletter September 2015

Documents

Transcript of The Advantage Newsletter September 2015