March 2015

In this issue

Medicare change may require action

We're serious about security

// TriState Advantage network improves access

HMP provider copay obligations

Rethink Your Drink materials remain available

Help us maintain an accurate email list

If your practice is changing email addresses, please let
Delta Dental know. Send the
updated information to us at or fax it to (888) 404-8725.

Delta Dental is phasing out the print edition of News You Can Use. The newsletter will be distributed solely by email beginning in 2016.

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TriState Advantage network improves access

Delta Dental invites you to increase access to oral health care in Michigan and Ohio by joining the TriState Advantage network, a new Delta Dental network that will serve government-sponsored programs and Medicare Advantage plans.

Participation in the TriState Advantage network offers the same great Delta Dental service and support, fast and accurate payments, and a way to attract new patients into your practice. Delta Dental remits benefit payments directly to participating dentists. Nearly 97 percent of claims are processed within 10 working days.

As with other Delta Dental programs, you and your staff will have access to the Dental Office Toolkit® and DASI (Delta Dental’s automated phone system). All claims under the TriState Advantage network must be submitted electronically and will be paid by electronic funds transfer (EFT). Participating dental offices will need to sign up for EFT if they have not already done so. Paper claims will not be accepted in the TriState Advantage network unless the claim is subject to an electronic claim submission exception found in the Administrative Simplification Compliance Act.

Participating dental offices are subject to audit by the Centers for Medicare and Medicaid Services (CMS). The TriState Advantage network is CMS compliant.

Members will be required to receive services from participating TriState Advantage network dentists. Participating dentists will be listed in our closed-panel directory, making it easy for potential patients to find them.

Reimbursement to all participating dentists for covered services rendered to members is based on the Delta Dental PPOSM fee schedule. A participating dentist cannot bill the member for any difference between his or her regular fees and the amount in the fee schedule.

Delta Dental of Michigan, Ohio, and Indiana