1. IN Provider Webinar IN Marketplace Launching January 2017

2. IN DentaQuest Provider Engagement Team
Please stay on this slide long enough for providers to write down their PE contact.

3. Agenda Plan overview Where plans will be available Who will enroll
Sample ID cards
Benefit overview
Contact phone numbers and addresses

4. What are the Marketplace plans?
Commercial insurance offered on Federal and/or State and Private Exchanges to individuals, families, and small groups
Open enrollment period is November 1 to December 31, 2016
Members will be effective January 1, 2017
Members will be able to Find a Dentist through DentaQuest at the following: 
Notes:
* DQ anticipates low initial member enrollment. ~200 members

5. Where is the plan offered in IN?
Plan will be available throughout the State.

6. Who may choose to enroll?
Persons who do not qualify for Medicaid or CHIP plans
Those who do not have dental insurance offered through an employer
Individuals, families, and small groups
Notes:
Voluntary program

7. How will the plan work? No waiting period for children under 19
Deductibles apply to certain services
No annual maximums for children under 19
Copayments/Coinsurance responsibility
Reimbursable rates are approximately 140% of traditional IN Medicaid fee schedule
Notes:
The 140% is on average, so this is subject to change, per code.
A copy of the marketplace fee schedule can be found on DQ’s provider portal under “Provider Documents” or by contacting your DQ PE Rep.

8. Eligibility Verification
To verify eligibility, log-in to DentaQuest’s new provider portal:
To register for DentaQuest’s new provider portal visit and click on the “Login” link. Then, choose “New Provider Portal”, and then “Register” and follow the directions.

9. Sample ID Cards- DentaTrust\

10. Sample ID Cards- DentaSpan\

11. DentaTrust/DentaSpan High Plans
Benefit Overview
DentaTrust/DentaSpan High Plans
Notes:
There are two plans that we will cover today.
We are going to cover areas in the next couple of slides, but please use the ORM as the source of truth to inform you.

12. DentaTrust/DentaSpan High Plans
Notes:
* Briefly mention that it’s important to watch for the patient’s Waiting Period.

13. DentaTrust/DentaSpan Low Plans
Benefit Overview
DentaTrust/DentaSpan Low Plans

14. DentaTrust/DentaSpan Low Plans

15. Where do I mail claims? DentaQuest PO BOX 2906
Milwaukee, WI
The Payor ID for electronic submission is: CX014
Providers have 90 days to submit claims to DentaQuest

16. How do I get more information?
DentaQuest’s Customer Service phone number is for providers
Office Reference Manual- Available 1/1/17
DentaQuest’s website:
DentaQuest’s new provider portal:
Notes:
Explain what the ORM is and that we are going to cover it in greater detail on the next slide, and that there is a different one than for HIP/HCC/HHW.
The ORM will be available 1/1/17, and you can find it on DQ’s microsite and DQ’s provider portal.

17. Office Reference Manual (ORM)- Available 1/1/17
Important address and phone numbers
Benefits and limitations
Claims filing information
Forms
Authorization information
Providers rights and responsibilities
Member eligibility information and samples of identification cards
Appeal procedures
Clinical criteria

18. Thank You
Thank you for being a part of DentaQuest’s dental network for the exchanges
Working together, we can improve the oral health of all!!
Notes
* If you would like a copy- PE rep can , we will post to microsite, and provider portal.
Questions?