From the desk of Mark Mitchke, CEO:
“We know you are working hard to balance the needs of your business while supporting your clients and employees. We want to assure you that we will do everything we can to limit disruption to the services we provide, and work with you in this unprecedented circumstance. We are adjusting our operations to keep our customer service team available for your employees to answer questions, and process claims.”
Read Mark’s full message
As always, if you have specific questions not addressed below, please reach out to your account representative or client manager.
Q: What are you doing to share COVID 19 communications at this time?
Our website, DeltaDentalWA.com, is available 24 hours a day – 7 days a week to provide members, clients and producers the most up to date information you need.
Our customer service team is continuing to work and answer questions at 1-800-554-1907.
Another new customer service enhancement is available: an automated self-service answer tree on our social media channels. It allows user to select a path toward an immediate answer to frequently asked benefit questions. Simply go to our Facebook or Twitter home pages and click “Send Message”.
We are communicating frequently, providing information, education and expert resources to keep our members informed.
Q: With DDWA offices closed, will customer service and claims processing still operate?
Yes. We are committed to ensuring our customers receive the care and services they need.
Although our offices are closed, our teams continue to work remotely. We are doing all we can to keep our customer service team available to you by phone at 1-800-554-1907.
We continue to meet all of our claims turnaround service levels:
- Claims paid in an average of 3.7 days after receipt
- 90% of claims submission are received electronically
- 80% of those claims are processed automatically
Q: Are you extending the premium grace period for groups and individuals members?
A: Yes, although we are not mandated to do so by the Office of the Insurance Commissioner, we are extending plan premium grace periods to 60 days for all fully-insured, pooled, negotiated groups as well as individual and family plan members.
Q: Are you extending self-insured claims payment grace?
A: We don’t expect any significant volume of claims due to the fact that non-essential appointments are being postponed.
The lower volume of claims should help large businesses manage claims calls.
Any employer that anticipates a hardship due to self-insured claims payment should reach out to their account management team.
Q: What are you doing to support a tele-dentistry option?
A: From a coding and claims perspective, we do not differentiate between in-person or tele-dentistry services.
Providers can submit the same code regardless of environment and it will be paid accordingly if the benefit is covered.
Q: Can employers waive leave of absence?
A: Yes. Eligibility is determined by the group, and as a result, we can waive the minimum hour requirement for benefits of existing full-time employees.
Q: What is your policy on furloughed employees?
A: The group determines eligibility for members. Our standard contractual language states, “A full-time employee is an employee who works a minimum of 80 hours each calendar month or as otherwise determined by the group.”
The flexibility of the standard language allows each employer to set their eligibility standards without impacting documentation with us.
We will support any eligibility decisions and work with you to document those changes if needed.
Q: Can a group term for one or two months and come back to the same plan, rates, etc.?
A: A group can term their members, and if they return within the same contract period, we will allow employees to pick up where they left off meeting deductibles and annual maximums.
Q: Are employees who are below the minimum number of hours required eligible for benefits?
A: Yes. Eligibility is determined by the group, and as a result, we can waive the 30 hour per week requirement for benefits for existing full-time employees.
Q: If groups have reduction in staff, will their rates change?
A: Our rates will not change due to a reduction in staff. They will stay in the same size tier as their current contract. Rates will also not be adjusted mid contract if a group has a reduction in staff during this time.
Q: What if a majority of the employees are in COBRA and not active status?
A: We will administer the benefits in the same way whether employees are sent as active or COBRA.
Q: When an employer lays off employees, when does their coverage end?
A: Coverage remains effective through the full month of paid premium.
Q: How will negotiated groups’ renewals be treated if they are temporarily below 99 due to COVID-19 at time of renewal?
A: Groups will remain in our negotiated group segment for the next renewal term.