Remote Dynamic Obligation Dental System Instructions.


66 views
Uploaded on:
Description
Remote Dynamic Obligation Dental Project Preparation. Displayed by Rich Panepinto Chief, Advantage Relations United Concordia (850) 995-9024. What is the ADDP?. New program that replaces dental cases handling already gave by the Military Restorative Bolster Office (MMSO) and different organizations.
Transcripts
Slide 1

Remote Active Duty Dental Program Briefing Presented by Rich Panepinto Manager, Benefit Relations United Concordia (850) 995-9024

Slide 2

What is the ADDP? New program that replaces dental cases preparing already gave by the Military Medical Support Office (MMSO) and different organizations. Two Distinct Components DTF Referred Remote Active Duty Dental Program (RADDP) Effective 1 August 2009 Authorized clients will be obliged to utilize a United Concordia system dental practitioner (Unless pre-approved by United Concordia) Must have an Appointment Control Number (ACN) if RADDP or Referral Number if DTF Referred

Slide 3

Current Dental Care ($) Referred to the Private Sector Costs for Dental Private Sector Care have expanded from $17.4 M in FY01 to $151.9 M in FY 08

Slide 4

Geographical Areas of Service 50 United States Guam Puerto Rico U.S. Virgin Islands American Samoa Northern Mariana Islands.

Slide 5

Who is qualified? Dynamic Duty Personnel of 5 Uniformed Services who live or work more than 50 miles from a military Dental Treatment Facility Guardsmen and Reservists on requests > 30 days Foreign military faculty positioned in the U.S. Early Activators Line of Duty Personnel Note: Personnel on TAMP are NOT qualified

Slide 6

ADSM Dental Readiness United Concordia will track Dental Readiness characterization for those ADSMs who use the ADDP . Private area dental practitioner will demonstrate Dental Readiness on case structure

Slide 7

ADSM Benefits will be given as determined in Attachment 2 of the ADDP contract Attachment 2 is accessible on the Web website at www.addp-ucci.com The ADDP will pay for secured dental advantages, treatment particularly approved by the Dental Service Point of Contact (DSPOC), and strategies that have gotten approval before receipt of consideration. In the event that you choose to get non-secured administrations, ADSM will be in charge of installment to the dental practitioner. Note: Uniformed Service-particular procedures (e.g.,evaluation sheets for orthodontics and inserts) are not influenced by the ADDP. Current techniques used by the Services still apply.

Slide 8

EMERGENCY Dental Care Emergency dental consideration does not require an Appointment Control Number. Crisis dental consideration incorporates any treatment important to diminish agony treat disease control draining repair broken fillings by position of provisional or perpetual fillings (not crowns). Root trench treatment may be expected to assuage the torment and disease, and is considered crisis dental consideration. Not needed to use a United Concordia dental practitioner, but rather prescribed. Subsequent consideration must be with a United Concordia system dental specialist.

Slide 9

Claims All dental consideration got under the ADDP must be gotten from a United Concordia system dental specialist to be qualified for installment. Cases will likewise be paid for those areas where there are no accessible network dental specialists. (as controlled by United Concordia)

Slide 10

Canceled and Missed Appointments If the ADSM can’t keep the planned arrangement, they ought to cross out it ideally no later than 24 hours before the booked time. - United Concordia must be told of the cancelation and reschedule date at 1-866-984-ADDP (2337) or email addpdcf@ucci.com . Uncontrollable issues at hand may keep the ADSM from crossing out inside of 24 hours of the arrangement. In the event that this happens, they can call United Concordia to reschedule. ADSM ought to call United Concordia on the off chance that they get a bill for the missed arrangement

Slide 11

Appeals Remote ADSMs are obliged to have an ACN preceding getting to non military personnel dental consideration. Without an ACN the case may be denied. May claim a disavowal by reaching United Concordia. Remote ADSM may approve the non military personnel dental specialist to record a request for your benefit by finishing the Authorization to Appeal” Form. Accessible on the ADDP site.

Slide 12

Grievances United Concordia is focused on giving quality results through our system of dental experts. We utilize benchmark usage surveys to guarantee system dental practitioners give industry-standard levels of treatment. United Concordia has entrenched Grievance and Appeal projects to guarantee persistent fulfillment and location quality concerns. On the off chance that there is a quality concern in regards to systems that have been performed by a United Concordia system dental specialist, please address them in the accompanying way: The ADSM ought to address the first occurrence in regards to clinical quality with the treating dental practitioner to give a chance to amend the worry. On the off chance that favored, the ADSM can ask for that United Concordia contact the treating dental practitioner for restorative activity. On the off chance that the treating dental practitioner does not adjust the issue after the starting demand, the ADSM ought to contact United Concordia to address the worries. To record a grievance, download the Grievance Form from the ADDP Web website (www.addp-ucci.com) and present a marked duplicate to United Concordia via mail or fax.

Slide 13

Civilian Providers Network Providers Network suppliers won\'t gather installment for secured strategies or later bill the ADSM for any approved and/or secured dental consideration. United Concordia will get the dental preparation classification data from suppliers. ADSMs won\'t be charged for these administrations. System dental specialists will give a duplicate of treatment endless supply of the ADSM. Note: If an ADSM chooses to get a non-secured dental strategy, the ADSM must be educated by the supplier, ahead of time of getting the treatment, that the method is rejected from scope and the ADSM consents to pay for the treatment.

Slide 14

Civilian Providers (proceeded with) Non-organize Providers If the ADSM is sanction for consideration from a non-organize supplier who requests installment in advance, the ADSM must contact United Concordia who will mastermind repayment to the supplier. At the point when an ADSM has paid a non-organize supplier in a crisis circumstance and looks for repayment, United Concordia will repay the ADSM.

Slide 15

Remote Active Duty Dental Program (ADDP) The Remote ADDP gives private segment dental consideration to Active Duty Service Members (ADSMs) who live or work 50 or more miles from a military Dental Treatment Facility (DTF).

Slide 16

Remote ADSM: Accessing Routine Care May by and by direction your routine secured dental consideration: (e.g. examinations, cleanings, fillings) the length of the dental treatment seems to be: (1) not exactly $500 per system or arrangement or (2) the total aggregate is not exactly $1,500 for treatment arranges that can be finished inside of a 12-month period AND (3) the strategy must be a secured advantage of the ADDP. Must FIRST get an Appointment Control Number (ACN) by finishing an Appointment Request Form.

Slide 17

Completing and Submitting an Appointment Request Form Access the Appointment Request Form through the ADDP Web website (www.addp-ucci.com) by tapping on the ADSM/Active Guard & Reserve entrance.

Slide 18

Remote ADSM: Appointment Request Form

Slide 19

Remote ADSM: Making the Appointment The Appointment Request Form gives two alternatives to arrangement booking: United Concordia’s Dental Care Finders can make the arrangement for ADSMs on the off chance that they select that choice. 2. Remote ADSMs can actually make a selecting so as to meet with a system dental practitioner the that choice in the “ Who will be in charge of booking the arrangement ” field on the structure.

Slide 20

Making the Dental Appointment 2 Options 1. Let United Concordia make the arrangement Dental Care Finders (DCF) will facilitate inside of two (2) business days UCCI will guarantee the accompanying: DEERS qualification Utilizing a United Concordia Network Dentist Appointment inside of 21 days for routine consideration Need quick arrangement: Call United Concordia DCF at 1-866-984-ADDP (2337)

Slide 21

Making the Dental Appointment (proceeded with) ADSM can make their own arrangement. * No particular dental specialist: Within two (2) days of the solicitation DCF will give a rundown of three system dental practitioners. ADSM can call a United Concordia system dental specialist specifically and mastermind the arrangement. * ADSM has a particular system dental practitioner: add dental practitioner contact data to the Appointment Request Form. After ACN is gotten ADSM can mastermind the arrangement * Must tell United Concordia of the arrangement date and time.

Slide 22

Remote ADSM: Making the Appointment Reminders Must hold up until you get the ACN from United Concordia before making an arrangement. Making your own particular arrangement obliges you to contact United Concordia with the dentist’s name, date and time of the arrangement so their records may be upgraded. Messaging to: addpdcf@ucci.com or calling 1-866-984-ADDP (2337). On the off chance that you experience issues getting an arrangement inside of 21 days of solicitation contact United Concordia at 1-866-984-ADDP (2337). You can decide to sit tight over 21 days for a particular supplier and waive your entitlement to an arrangement inside of 21 days.

Slide 23

Remote ADSM: Accessing Specialty Care Remote ADSMs must get approval before receipt of dental tend to: Specialty care (e.g. crowns, spans, dentures, periodontal treatment) Dental consideration in overabundance of $500 per methodology or arrangement Dental consideration with a combined aggregate more noteworthy than $1,500 for treatment arrangements Receiving dental consideration from a non-organize dental specialist Note: For insert and orthodontic strategies, Remote ADSM will likewise require a Command Memorandum from their unit marked by the unit administrator or assigned agent. This ought to be put together by the non military personnel dental practitioner as a connection with the finished Authorization Request Form.

Slide 24

Remote ADSM: Accessing Specialty Care To get approval, Remote ADSMs must have their non military personnel dental specialist finish an Authorization Request Form. Thi

Recommended
View more...