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GEHA Dental claims reviews

Wednesday, October 6, 2021 | Posted in GEHA Connection Dental Network Provider Newsletter

GEHA Dental claims reviews

On May 1, 2021, GEHA partnered with P&R Dental Strategies for dental claim reviews. To ensure proper processing and avoid delays in payment of submitted claims, please review our claim submission guidelines on our website at geha.com/why-geha/customer-care/faqs.

If you have questions or experience unexpected outcomes because of this change, please reach out to GEHA Customer Care at 877.434.2336.

Now available: Automated fee schedule faxback

You can now request a copy of your Connection Dental Network fee schedule through an automated interactive voice response (IVR) system. This allows you to receive a faxed copy of your fee schedule 24 hours a day, 7 days a week, by following a provider validation prompt on the IVR system. Get your fee schedule today by calling 800.505.8880 and follow the requested phone prompts. Remember, you can also log into the provider portal to view and print your fee schedule at connectiondental.com.

Pain management for dental medicine in 2021: Opioids, COVID-19 and beyond

The prescription opioid crisis is an issue that involves all sectors of U.S. society and affects every community, socioeconomic group and age group. An estimated 23 percent of prescribed doses are used nonmedically; as prescribers of 12 percent of immediate-release (IR) opioids in the U.S., dentists share the responsibility of reducing the potential for opioid misuse and abuse as well as effectively treating their patient’s pain.

Dentists can help minimize opioid abuse through patient education, careful patient assessment and referral for substance abuse treatment when necessary and using tools such as prescription monitoring programs. While research is needed to determine an optimal number of doses to treat dental-related pain, pain can be a subjective experience. Be alert to drug-seeking behavior in the context of pain management and treat each patient carefully and sensitively, as unrelieved or unremitting pain can be a relapse trigger for recovering chemically dependent patients. Consistent education and screening of patients, as well as developing a referral network for treating opioid abuse are recommended courses of action that can be implemented.

Source:

pubmed.ncbi.nlm.nih.gov/34079355
pubmed.ncbi.nlm.nih.gov/10516924
pubmed.ncbi.nlm.nih.go
pubmed.ncbi.nlm.nih.gov/21719802.

Medicare Advantage payors

Did you know that some Connection Dental Network payors offer Medicare Advantage plans in addition to commercial plans? Medicare Advantage plans use the same Connection Dental Network fee schedules as commercial plans. Currently, Medicare Advantage plans are offered by Humana, Dominion National, UnitedHealthcare, Paramount Dental and United Concordia Inc. It is crucial to verify benefits and eligibility with the insurer and/or payor prior to performing services. Contact the Payor directly for your participation status within each of their network plans or products, and/or for a complete list of all network plans and products the Payor offers to consumers, as applicable.

Directory requirements and importance of updating your information

Connection Dental Network has policies and procedures in place to ensure we have the most current directory information available for our providers. However, we need your help. The importance of keeping this information up to date is so patients have access to accurate information. This will also ensure that new patients are able to locate participating providers. In addition, when our providers complete directory updates in a timely manner and submit address change forms, this helps payors identify the correct claim payment mailing address. For more information about directory updates, please contact us at 1.800.505.8880 or visit our website at connectiondental.com

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