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Dental Bulletin

Winter 2017

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In this issue: 

Another Strong Year for PacificSource Dental >

With PacificSource-Legacy Partnership Finalized, Portland Recruiting Ramps Up >

Targeted Reminders Lead to More Preventive Care >

CDT 2017 Dental Code Changes >

Prescription Drug Monitoring Programs (PDMPs) Help Ensure Safe Prescribing >

3 Tips for Successful E-claim Attachments >


Another Strong Year for PacificSource Dental

“Our success wouldn’t be possible without the quality dental care you provide our members. We appreciate all you do as Advantage providers.”

– Dr. Jim Gimarelli, PacificSource Dental Director

2016 has been another wildly successful year for the dental product at PacificSource, with strong financial performance, a growing network, superior sales and customer retention, and great claims and customer service results. In particular, we have achieved all-time high marks in the following categories:

  • Most large group dental cases sold (groups larger than 50 employees): 14 new sales, representing more than 6,000 new members.
  • An average dental claims turnaround time of 8.26 days.
  • An increase in dental customer retention to 82 percent overall with greater than 90 percent retention on groups over 25 employees.

As we look to 2017, we’ll continue to focus on our core dental product strengths — prevention, the Advantage Network, a diverse product portfolio, and claims and customer service capabilities.

With PacificSource-Legacy Partnership Finalized, Portland Recruiting Ramps Up

FamilyThe partnership between PacificSource and Portland-based Legacy Health has been finalized as of September 1, 2016. Through this relationship, both Legacy and PacificSource will work toward achieving their healthcare triple aim of better care, better cost, and better health.

“It gives me great pleasure to announce that our two organizations are now officially partners, and we can move forward together with shared goals and a vision for improving healthcare for our members and the communities we serve,” said Ken Provencher, president and CEO of PacificSource Health Plans.

Given this stronger presence in the Portland metro area, PacificSource is increasing efforts to expand the Advantage Dental Network in this region. During the first six months of 2017, PacificSource and Advantage are collaborating to deliver a multichannel marketing campaign to recruit Portland dentists into the network. While recruitment occurs year round, this extra push in the first two quarters will position us to better serve the anticipated influx of new members.

For more information on the Legacy partnership, please read the news release at

Tooth with CalendarTargeted Reminders Lead to More Preventive Care

As we know, those who receive regular dental checkups and cleanings have better dental and overall health. And sometimes, a simple reminder can make a big difference. This past April, we sent emails and postcards to our members with dental coverage who had not seen a dentist in the previous 12 months. The message encouraged them to contact their dentist to schedule an appointment. As a result, several hundred of these members made dental appointments for cleanings and exams in May and June. Due to the strong response to this program, we are evaluating how to use this approach going forward.

CDT 2017 Dental Code Changes

Browser with PencilThe American Dental Association has recently published CDT 2017, which will replace CDT 2016 as the official reference for documenting dental services provided between January 1 and December 31, 2017. Per PacificSource policy, CDT 2016 codes will continue to be accepted for the first three months of 2017, but will not be processed after March 31, 2017.

Eleven new CDT codes have been added for 2017. Of these, three will be covered by PacificSource with some limitations:

  • D1575 Distal shoe space maintainer – fixed – unilateral
  • D4346 Scaling in the presence of generalized moderate or severe gingival inflammation – full mouth, after oral evaluation
  • D6081 Scaling and debridement in the presence of inflammation or mucositis of a single implant, including cleaning of the implant surfaces, without flap entry and closure

A fourth new code (D6085: Provisional implant crown) will be covered for PacificSource members with an implant benefit.

Prescription Drug Monitoring Programs (PDMPs) Help Ensure Safe Prescribing

Prescription PadThe Prescription Drug Monitoring Program (PDMP) is a tool to help healthcare providers and pharmacists provide patients better care in managing their prescriptions. PDMPs collect, monitor, and analyze electronically transmitted prescribing and dispensing data submitted by pharmacies and dispensing practitioners. The data are used to support states’ efforts in education, research, enforcement, and abuse prevention.

Evidence shows that PDMPs are effective in several ways:

  • Improving clinical decision-making
  • Reducing doctor shopping
  • Reducing diversion of controlled substances
  • Assisting in other efforts to curb the prescription drug abuse epidemic.

PDMPs have been enacted in 49 states, including all Pacific Northwest states. Unfortunately, these programs continue to be underutilized by many provider types, especially dentists. A study of PDMP utilization in Oregon found that 70 percent of dentists surveyed prescribed opioids at least weekly, but only 39 percent had registered to use the PDMP. Surveys from other states have shown similar utilization patterns by dentists. 

Consistent use of state PDMPs is one of the strategies recommended by the American Dental Association for safe prescribing of opioid analgesics. For more information about state Prescription Drug Monitoring Programs, including how to register, we encourage all Advantage dentists to visit their state website below:





3 Tips for Successful E-claim Attachments

Hands on LaptopIf you need to attach x-rays, perio charts, EOBs, narratives, or other documentation with your dental claim to PacificSource, please keep the following in mind.

  • While we receive a daily report of NEA attachments, we also suggest you put the NEA number in the remarks section on your claim form. This will alert us to review the attachment and allows for quicker review.
  • If we cannot access your attachments, you may receive a letter asking for the information. No need to send a new claim or a copy of the existing claim; simply send us the information by mail or email, and reference the claim number shown on the letter.

Questions? We’re Happy to Help

Contact PacificSource Dental Customer Service for Questions Concerning:

  • Member benefits or eligibility
  • Status of a specific claim or EOP


Eugene: (541) 225-1981
All other areas: (866) 373-7053

Fax: (541) 225-3655

Contact Advantage Provider Relations for Questions Concerning:

  • Becoming a contracted provider
  • Provider contracts


Phone: (866) 268-9616


Fax: (866) 268-9318

3PRV 012017


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