Delta Dental of Colorado 2016 Annual Report

The Transformative Power of a Smile

Kate and Helen

Do you know what happens when you smile? Your brain generates endorphins, which affects the biochemistry of your whole body and makes everything work better, ultimately resulting in being calm, receptive, clear, and happy. It’s a pretty incredible chain reaction caused simply by the act of smiling. And healthy smiles truly have the power to transform a life through improved overall health and wellness. It’s a positive change and a powerful transformation.

Winston Churchill said, “To improve is to change; to be perfect is to change often.” This past year has been a time of tremendous change within the walls of Delta Dental of Colorado. Our president and CEO Kate Paul retired in December of 2016, and we embarked on a new course with CEO and president Helen Drexler at the helm. It’s not just a change in leadership, but it’s indicative of a bigger shift within our company. It affects how we meet the needs of our members, providers, employers, and brokers as well as the shifts within the marketplace.

We know that we must change and adapt to continue to serve our more than 1.2 million members, 3,200 providers, and 5,500 employers in the best way possible. We are building on the strengths and the skills we have honed over the past 59 years, and we are moving toward the future in new and innovative ways. To be innovative, to meet the demands of the marketplace, to help our providers continue to serve their patients in the best way possible — these all require transformation. So we are focused now more than ever on new products, new ways of thinking about dental benefits, new ways to support our mission of improving the oral health of the communities we serve, and new ways of making dental insurance, dental care, and good dental health more accessible to more people.

You will hear us talk in the coming years about the importance of dental-medical integration as we work to dispel the notion that oral health somehow exists independently of overall health. By integrating a dental hygienist into health clinics through the work of our company and foundation, we are helping to close that gap.

A wise man once said, “Change will not come if we wait for some other person or some other time.” At Delta Dental of Colorado, we are busy transforming our business to bring Smile Power™ to all Coloradans right here, right now.

A Changing Landscape

Delta Dental of Colorado is constantly striving to make it a reality by working to achieve our mission of improving the oral health of the communities we serve.

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Innovation

182,511 App Downloads
12,230 App Logins
284,786 Text Messages Sent
  • Listening to the Voice of the Customer to Transform the Customer Experience

    Understanding the customer experience is a key strategic objective for Delta Dental of Colorado.

    Read More
  • Changing Ideas about Oral Health Through Text Messaging

    In 2015, we started an innovative text messaging program that focused on subscribers of the Child Health Plan Plus program.

    Read More
  • Innovative Ideas That Will Transform Oral Health Care

    Five Colorado-based organizations are working to improve oral health as the 2016 Delta Dental of Colorado Foundation Innovation Grant recipients.

    Read More

Access

706,348 Subscribers
1,257,780 Members/Enrollees
56,076 New Members in 2016
$386.4M Total Revenue
2.2M Claims Serviced
97.24% Retention Rate
  • Robust Group Sales Continue to Expand Access to Dental Benefits

    2016 was a strong sales and retention year for Delta Dental of Colorado as we continued to grow and expand dental membership across Colorado and the nation.

    Read More
  • SpringRock Dental Expanding Access to Underserved

    SpringRock Dental is continuing to expand access to oral health care for traditionally underserved populations by delivering high-quality, cost-effective care.

    Read More

Education

Dental Dental of Colorado sent 2,408 social media messages in 2016, reaching 1,760,237 Coloradans, and generating 24,568 engagements.

  • Sharing Smiles on Social Media

    Our work educating about the importance of oral health and working to increase insurance literacy was recognized by the Delta Dental Plans Association and Colorado Healthcare Communicators.

    Read More
  • Laughing about Oral Health

    Land of Smiles is a live performance that teaches children in kindergarten through third grade about good oral health care.

    Read More
  • A Lifetime of Smiles & Good Health

    In 2016, Delta Dental launched LifeSmile, a complete oral wellness program that helps employees focus on their oral health and well-being.

    Read More

Outreach and Advocacy

  • Delta Dental of Colorado Foundation

    Funded by Delta Dental of Colorado, the Delta Dental of Colorado Foundation has provided support to communities across the state.

    Read More
  • Increasing Access to Preventive Care in Medical Settings

    Last year, Coloradans received more than 20,000 visits that transformed their smiles through the Colorado Medical-Dental Integration project (CO MDI).

    Read More
  • Transforming Oral Health Norms in Communities

    Our statewide Cavities Get Around campaign engages caregivers and influencers on the importance of baby teeth.

    Read More

Community Involvement

21 Events & Tooth Fairy Appearances
28,631 Toothbrushes Donated
38,124 Toothbrushes Given Out at Events
567 Employee Volunteer Hours
53 Employee Volunteers on Employee Day of Service
54 Family & Friend Volunteers on Employee Day of Service
  • Honoring our Mission Transforms Smiles

    The community benefit program drives the company mission to improve the oral health of the communities we serve.

    Read More

Network and Clinical Focus

3,238 Premier Providers
2,261 PPO Providers
89.3% of Employers Choosing PPO Plans
150 Attendees at Free Dental Office Seminars
428 Attendees at Free CPR Trainings
  • Using the Power of Technology to Keep Smiles Healthy

    In 2016, our network management team worked with providers and their office staff by offering hands-on training and support to integrate Dentalytics into their practices.

    Read More
  • Transforming Teams to Meet Stakeholder Needs

    Formerly known as “provider services,” our network management team does so much more than just stop by participating dentists’ offices to say hello.

    Read More
  • The Strength of our Clinical Management Team

    In 2016, we saw some changes and growth in our clinical management team, starting with a name change from dental review to clinical management to better reference the work being done and the clinical knowledge the team brings to the company.

    Read More
  • Focusing on Dental-Medical Integration to Help Members Achieve Better Oral and Overall Health

    At Delta Dental of Colorado, we mean what we say when it comes to oral and overall health being strongly connected.

    Read More

Financial Results

Balance Sheet

Years Ended December 31 (in thousands)

Assets 2016 2015
Cash and investments $120,784 $116,163
Accounts receivable, net 20,598 19,596
Property and equipment, net and other assets 6,762 5,745
Total Assets $148,144 $141,504
Liabilities    
Unpaid claims and claim adjustment expenses $15,731 $15,792
Accounts payable and accrued liabilities 14,848 15,421
Total Liabilities $30,579 $31,213
Reserves    
Company reserves, restricted $81 $168
Company reserves, unrestricted 117,484 110,123
Total Reserves $117,565 $110,291
Total Liabilities & Reserves $148,144 $141,504

Statement of Operations & Changes in Reserves

Years Ended December 31 (in thousands)

Total revenue from operations $380,920 $357,301
Net investment income 5,487 2,819
Total Revenue 386,407 360,120
Benefits for services to members and operating expenses 371,933 349,397
Grants and community benefit expenditures 7,200 7,906
Net change in reserves 7,274 2,817
Reserves at beginning of year $110,297 $107,484
Reserves at End of Year $117,565 $110,291

Board of Trustees

2016 Delta Dental of Colorado Board of Trustees

2016 Board

Back Row (Left to Right):

Leo Tokar
Senior Vice President, Health & Welfare Practice, Lockton Companies
Thomas Swain, DDS
General Dentist
Douglas Berkey, DMD, MPH, MS
Professor Emeritus, University of Colorado School of Dental Medicine
Hassan Salem
President, U.S. Bank – Colorado, and Regional President, U.S. Commercial Banking – CO, NV, UT, AZ
Bruce N. Calogne, MD, MPH
President and CEO, The Colorado Trust
Jonathan Anderson, DDS
General Dentist

Center Row (Left to Right):

Walt Vogl, DDS
General Dentist
Kelly J. Brough
President and CEO, Denver Metro Chamber of Commerce
Victor Lazzaro Jr.
Managing Partner, Volante Capital Advisors, LLC
Marilyn Taylor*
Retired Vice President for Human Resources, Xcel Energy
Mary Noonan
Retired Insurance Industry Executive

Front Row (Left to Right):

John P. Hopkins
Retired Chief Executive Officer, Rocky Mountain Health Plans
Mark Wehrle
Retired Partner, Deloitte & Touche
Kim Kretsch, DMD
Pediatric Dentist
Kathryn A. Paul
President and CEO, Delta Dental of Colorado
(through December 19, 2016)
Donald Safer, DDS, MS
Retired Endodontist

Not Pictured:

Helen Drexler
President and CEO, Delta Dental of Colorado
(as of December 19, 2016)

* Chairman, Delta Dental of Colorado Board of Trustees

Leadership Team

2016 Delta Dental of Colorado Senior Leadership Team

2016 Board

Back Row (Left to Right):

Jean Lawhead
Vice President, Sales & Marketing
Barbara Springer
General Counsel/Vice President/Foundation Executive Director
Greg Vochis
Interim Chief Financial Officer
David Beal
CEO, SpringRock Dental
Linda Arneson
Vice President and Chief Operating Officer

Front Row (Left to Right):

Cheryl Lerner, DMD
Vice President, Network & Clinical Management
Kathryn A. Paul
President and Chief Executive Officer
(through December 19, 2016)
Dave Gerbus
Vice President of Administration and General Counsel
(as of September 1, 2016)

Not Pictured:

Helen Drexler
President and Chief Executive Officer
(as of December 19, 2016)

CloseThe Importance of Oral Health in a Changing Health Care Landscape

Delta Dental of Colorado believes that a healthy smile contributes to a happier, healthier life. It’s called Smile Power™. Everyone deserves that, and Delta Dental of Colorado is constantly striving to make it a reality by working to achieve our mission of improving the oral health of the communities we serve.

As we approach new challenges in the marketplace and welcome new leadership internally, our dedication to that mission remains constant while the value that we bring to our clients and our communities continues to grow. The fundamentals that we have built our company around help us build on our strengths while embracing change and creating innovative solutions.

Delta Dental of Colorado is a…

TRUSTED PARTNER

By striving to make dental coverage more accessible and affordable, we help our more than 1.2 million members get the oral health care they need.

DENTAL LEADER

Unlike most carriers, we focus on just one thing — dental insurance. That means that dental comes first; it’s not secondary to medical benefits. Our highly skilled network & clinical management staff members bring years of experience in dental office settings to help guide members in using their dental benefits and educate providers about clinical trends.

COMMUNITY ADVOCATE

As a nonprofit, our mission is to improve the oral health of the communities we serve. This mission — not profit — drives everything we do.

LOCAL LEADER

Delta Dental of Colorado is the state’s leading dental benefits company and the only one based in Colorado. We keep our operations local by housing our entire organization — from the call center to sales support — within our Denver Tech Center office. And 92% of all dentists in Colorado are a part of our Delta Dental PPOSM and Premier® networks.

And there’s one more we’d like to add to that:

INNOVATIVE THINKER

We are constantly searching for new ways to help you take the best care of your dental health. From innovative tools to new plan designs, we are the leading the way in changing how people think about and use their dental benefits.

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CloseListening to the Voice of the Customer to Transform the Customer Experience

Understanding the customer experience is a key strategic objective for Delta Dental of Colorado. It drives our decisions on new products and services and creates an opportunity for innovation. In 2016, we launched a formal Voice of the Customer program to understand what drives satisfaction for members, employers, and our dental community. This information allows us to pinpoint areas where we can improve service and look for opportunities to provide innovative solutions.

One specific area we have been focusing on is helping members understand the value of their dental insurance coverage. We found that our members don’t fully understand their benefits coverage and the fact that preventive office visits are almost always covered at 100%. Because we are seeing families that aren’t scheduling routine preventive visits, we created a product concept that covers all children’s dental care at 100% up to age 13. Our goal is to encourage early preventive care for our members, which will lead to improved overall health.

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CloseInnovative Ideas That Will Transform Oral Health Care

Five Colorado-based organizations are working to improve oral health as the 2016 Delta Dental of Colorado Foundation Innovation Grant recipients. In partnership with Delta Dental of Colorado, the foundation awarded $220,000 to develop and test creative approaches to improve oral health.

“These projects hold tremendous promise, addressing head-on some of the most pressing oral health challenges Coloradans face,” said Allison Cusick, executive director of Delta Dental of Colorado Foundation.

Recipients include researchers, nonprofits, and high-tech companies throughout the Front Range:

  • Colorado School of Mines’ Krebs Research Group will work to advance regenerative materials for teeth. This new approach for treating a cavity would restore a tooth to its original condition, eliminating the need for a traditional filling.
  • Sharklet Technologies will apply its biomedical technology to a dental setting to produce bacteria-resistant retainers and other devices.
  • Quadric BioMed will work to bring to market a new type of dental implant that could significantly reduce bacteria build-up common with traditional implant devices.
  • Dental Aid seeks to reduce emergency department visits and overall cost of care by directing patients to dental providers and establishing dental homes for patients.
  • Clinica Family Health Services will develop new practice-management tools to improve dental care quality at its clinics.

“It’s inspiring to see so much innovation happening in oral health right here in Colorado,” said Dr. Cheryl Lerner, vice president of network & clinical management for Delta Dental of Colorado.

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CloseRobust Group Sales Continue to Expand Access to Dental Benefits

2016 was a strong sales and retention year for Delta Dental of Colorado as we continued to grow and expand dental membership across Colorado and the nation, which, in turn, helps to improve the oral health of the communities we serve. We owe our providers, brokers, employers, alliance partners, and members many thanks for our success in 2016. Our new group membership grew by 56,000 — 73% higher than the prior year and above the five-year average. Group retention, the ultimate measure of our success, ended the year at 97% — the tenth consecutive year that retention was above 95%.

Although these growth and retention results are impressive, we continue to have a challenging marketplace with more than 20 carriers competing for dental business and growing benefit cost pressures for employers and employees. We remain confident that our unwavering focus to offer the largest provider network in Colorado and the nation, our expertise in and singular focus on dental benefits, a strong commitment to local service, and creating new, innovative dental plans at a reasonable price will allow us to deliver strong results in the coming years.

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CloseChanging Ideas about Oral Health Through Text Messaging

Transforming people’s notions about the importance of oral health — especially children’s oral health — is one of the greatest challenges we face at Delta Dental of Colorado. Our mission is to improve the oral health of the communities we serve, and to continue to reinforce the importance of oral health, we have to find innovative ways to reach our members.

In 2015, we started an innovative text messaging program that focused on subscribers of the Child Health Plan Plus program. Many parents whose children are covered by CHP+ are unaware that their child also has dental coverage through this state program, and many benefits go unused. In 2013, 91% of kids with CHP+ or Medicaid visited a doctor, but only 40% visited a dentist. So we needed to find a way to continually reinforce the importance of using their child’s dental benefits. In 2016, we significantly increased the number of text messages we sent to parents from 40,000 to nearly 265,000. Messages were sent in both English and Spanish.

The program contributed to the submission of more than 20,000 unique claims for children whose parents received the text messages. We know dental insurance is not top of mind, but with occasional reminders sent to smartphones, people can look up information and make appointments right on the spot and better utilize their benefits.

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CloseSpringRock Dental Expanding Access to Underserved

SpringRock Dental is a dental delivery model started in 2015 by Delta Dental of Colorado to help ensure that all people, especially those who are underserved, have access to oral health services. Our first location at Kaiser Permanente Aurora Centrepoint Medical Office Building was a new, integrated approach to caring for the community's oral health. Ninety percent of diseases have signs or symptoms that appear in your mouth first. SpringRock Dental is helping bring dental and medical care together by co-locating a hygienist in Kaiser Permanente’s medical practice. And the Centrepoint location is critically important because it serves an area with a significant population of Medicaid enrollees.

SpringRock Dental is continuing to expand access to oral health care for traditionally underserved populations by delivering high-quality, cost-effective care to the underserved — with a particular focus on adults on Medicaid — in a new Aurora dental practice, located at 990 S. Abilene Street. There are 1.1 million Medicaid enrollees in Colorado, but only a third of the state’s dentists accept Medicaid. Approximately a quarter of the counties in Colorado have no dentists who accept Medicaid. Too many adults and children have limited access to dental services, and there are too few providers available to those on Medicaid and CHP+ or who have no dental insurance at all. SpringRock Dental opened this practice at this Aurora location because there is a large Medicaid population with limited access to dentists who accept Medicaid and because many of our Kaiser Permanente hygiene patients are in need of access to restorative dentistry.

SpringRock Dental believes that everyone deserves access to high-quality, affordable health care, regardless of economic or insurance status and continues to focus on improving access for underserved, low-income populations to improve oral health.

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CloseSharing Smiles on Social Media

The Delta Dental of Colorado–based social media collaborative led social media thought leadership in the Delta Dental system for 13 member companies, including Delta Dental of Colorado, in 2016. Our work educating about the importance of oral health and working to increase insurance literacy was recognized by the Delta Dental Plans Association and Colorado Healthcare Communicators.

In 2016, Delta Dental of Colorado's messages reached two million people and garnered 2.7 million impressions. We have a total of 30,343 followers throughout our social media channels. Our blogs had a total of 11,849 visits. Social media created 74 leads for individual product sales, and we answered 201 customer service inquiries.

In 2016, we disseminated 2,408 messages on social media including:

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CloseLaughing about Oral Health

Land of Smiles is a live performance that teaches children in kindergarten through third grade about good oral health care. The Tooth Wizard and Plaque Man use humor to demonstrate the importance of kids caring for their teeth. The program started in Colorado in 2014, visiting more than 50 schools. In 2016, Land of Smiles reached 6,500 more Colorado students, including those at nine schools in Grand Junction, Montrose, Olathe, and Clifton.

2016 Results

  • Schools visited: 105
  • Students visited: 28,414
  • Schools with >75% eligible for free/reduced lunch: 30
  • Post survey results showed an increase in student knowledge about oral health. Nurse and teacher survey results about the show were also positive:
  • 95% said their students were engaged throughout the program.
  • 100% would like to see the program return to their school.
  • 90% are very likely to recommend the program to a friend or colleague.

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CloseA Lifetime of Smiles & Good Health

In 2016, Delta Dental launched LifeSmile, a complete oral wellness program that helps employees focus on their oral health and well-being with tools, tips, and touch points for improving and maintaining good dental health habits.

Delta Dental of Colorado piloted this program with 27 employer groups serving nearly 300,000 members. After an analysis of specific claims data, we customized an education/outreach plan for each employer that specifically addressed the oral health issues of a client’s employee population. By creating specific content calendars based on their employees’ utilization patterns, the collateral — flyers, posters, postcards, rack cards, and email blasts — were customized and targeted. Employers could then choose to use this program — intended to help educate their employees about the importance of their oral health, how it relates to their overall health, and how they can best use their dental benefits to take care of it — in different ways to reach their employees like posting flyers and posters in break rooms, putting electronic flyers on their company wellness or intranet site, or including articles on oral health in employer newsletters.

The goal of this program is to increase utilization of preventive dental benefits, helping to reduce the number of more extensive treatments, increasing oral and overall wellness. Small changes in lifestyles can help our members achieve a lifetime of smiles and good health!

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CloseDelta Dental of Colorado Foundation

Tooth decay is mostly preventable, yet it continues to be the most common chronic childhood disease. Eighty percent of oral health problems are in 20 percent of the population. Children most affected tend to live in low-income households. Cavities can cause painful infections and create problems for kids trying to eat, speak, and learn. This is why Delta Dental of Colorado Foundation works to eradicate childhood tooth decay. Our approach includes:

  • Reaching low-income, high-risk families to promote oral health with educational programs and community-led efforts.
  • Expanding access to care by pilot testing new models of delivering care.
  • Supporting opportunities for medical and dental students and providers to learn about their role in oral and overall health.

Funded by Delta Dental of Colorado, the foundation has provided support to communities across the state. Our board fosters a vision that has transformed how we approach improving oral health. Today, our initiatives and work with our partners drive oral health innovations including:

  • Engaging communities about the importance of oral health through public will building.
  • Integrating hygienists into medical practices as a member of the care team.
  • Designing interdisciplinary learning opportunities for health profession students, residents, and practitioners to increase oral health awareness in relation to overall health.

Barbara Springer served as the executive director of the foundation for the last decade. In 2016, she announced her retirement. To honor Barbara’s commitment to helping the underserved, the foundation and the University of Colorado School of Dental Medicine announced the Barbara Springer Endowed Scholarship in Pediatric Preventive Dentistry. Barbara passed the executive director torch to Allison Cusick on December 1, 2016. Allison carries forward our commitment to improve the oral health of Colorado’s children.

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CloseIncreasing Access to Preventive Care in Medical Settings

Last year, Coloradans received more than 20,000 visits that transformed their smiles through the Colorado Medical-Dental Integration project (CO MDI). These visits were patients who received dental hygiene services at their medical practice. The population was 70% Medicaid and most of the rest were CHP+ or uninsured.

Located in a setting that is convenient and familiar to families, CO MDI clinics break down common access-to-care challenges including location, insurance status, and transportation issues. The hygienist, who is an integrated part of the medical care team, offers patients services during their medical visit.

Patients have access to the full range of preventive dental hygiene services in a dental exam room located within the medical space. Those with restorative needs are referred to receive care from local dentists.

Seven of the 15 medical practices participating in the CO MDI project completed the implementation phase at the end of 2016. Those practices are continuing to refine their care models. They still receive support and report data that helps show the impact of this work. The other clinics continue to make progress toward project completion.

The vision is to create sustainable medical-dental integration models that can be replicated. To extend the reach of services further throughout the state, CO MDI will expand to ten additional medical practices by late 2017.

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CloseTransforming Oral Health Norms in Communities

Public will building is about changing social norms and creating new expectations for children’s oral health. That means communities come to expect children to be cavity-free. Our statewide Cavities Get Around campaign educates and engages caregivers and influencers on the importance of baby teeth. In 2016, this bilingual campaign strengthened direct outreach in local communities and reached people disproportionately affected by early childhood tooth decay.

The campaign increased awareness through advertising, text messaging, and policy change.

  • We put a community frame on the importance of children drinking only water with an award-winning TV ad. All-new TV, radio, digital, billboard, and mass transit ads, delivered more than 50 million targeted impressions across the state.
  • Through Bright By Three, 43,000 text messages educated families statewide about their children’s oral health.
  • New regulations for all licensed childcare centers in Colorado prohibit serving children sugar-sweetened beverages and capped 100% juice to twice per week.

Much of the focus this year also included working with partners locally to create healthier environments.

  • In southwest Denver and southeastern Colorado, our partners increased efforts to create healthier environments for children. Fifth-graders at Math and Science Leadership Academy worked with Westwood Unidos to improve school wellness.
  • Qualistar Colorado launched Cavity Free Kids, an oral health program for early childcare educators. Seventy percent of trainees participating in the evaluation reviewed or changed their center beverage policy to make it healthier.
  • Metro Denver county health departments formed the Healthy Beverage Partnership. Their efforts increase awareness of the health impacts of sugary drinks.

When we work together, we have the ability to create healthy, sustainable change for kids.

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CloseHonoring our Mission Transforms Smiles

The community benefit program drives the company's mission to improve the oral health of the communities we serve. Through this program, various organizations throughout the state received more than 28,000 donated toothbrushes. The Delta Dental Tooth Fairy led our charge to educate the public about the importance of oral health at 21 sponsored events, where we handed out an additional 38,000 toothbrushes. Company culture inspires employee philanthropy. Employees donated more than 567 volunteer hours at these events as well as our day of service.

2016 Day of Service Volunteers

Annual company-wide support of Mile High United Way engaged employees in fun ways throughout the year. In 2016, employees collected 2,454 diapers and 5,543 food items to help Colorado families. We also came together to donate more than $91,000 to United Way programs.

At the end of the year, the company made a $1.5-million gift to support the dental hygiene programs offered by the Colorado Community College System. This gift provides student scholarships, faculty support, and funding for state-of-the-art equipment acquisition. Our goal is to advance the field of dental hygiene in Colorado by:

  • Attracting and retaining top faculty to work in high-quality educational facilities and programs.
  • Ensuring programs have current equipment, technology, and supplies to foster a learning environment centered on evidence-based dental care.
  • Providing scholarships for dental hygiene students, prioritizing students who are committed to career paths in public health or community clinics, education, and/or rural communities.

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CloseUsing the Power of Technology to Keep Smiles Healthy

Dentalytics, initially introduced in 2015, is a Web-based tool for participating Delta Dental network providers. The tool is focused on getting patients in for ADA-recommended preventive treatment. In 2016, our network management team worked with providers and their office staff by offering hands-on training and support to integrate Dentalytics into their practices.

By offering this free resource to our providers, we are working together to improve oral health and increase utilization by our members. Delta Dental values our participating providers and is committed to continued identification of innovative ways to support and partner with them. As of December 31, 2016, 536 providers were engaged with this tool, and we continue adding providers.

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CloseTransforming Teams to Meet Stakeholder Needs

Formerly known as “provider services,” our network management team does so much more than just stop by participating dentists’ offices to say hello.

The network management specialists (formerly, provider representatives) set up meaningful visits with our contracted offices to evaluate and discuss opportunities for enhancement of workflow processes, desktop procedures, accuracy of current provider listings, as well as offer value-added options — such as discounts to services, use of electronic funds transfer and e-claims — that are useful in a dental practice.

Our network administration specialists are the in-house support team members who ensure that changes to providers’ demographic and contractual information allow for accurate claim processing. With additional focused training on account management, we create a top-shelf service experience for all stakeholders.

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CloseThe Strength of our Clinical Management Team

In 2016, we saw some changes and growth in our clinical management team, starting with a name change from dental review to clinical management to better reference the work the team is doing and the clinical knowledge they bring to the company. The department expanded by adding two new clinical review specialists, both registered dental hygienists. They also added an additional position — clinical systems support specialist — to the team. This individual is also a registered dental hygienist who assists in clinical support for building group benefits and frequency limitations. The clinical management department also took over the processing of provider credentialing applications.

The clinical management team has been able to provide more outreach to our providers to obtain clinical information for claims and credentialing file processing. The department has also worked closely with sales and client services to review benefits and provide clinical recommendations for new groups. Working closely with group administration, the team has helped to better build benefit classes and tables, update frequency limitations to better reflect dental standards, and give clinical recommendations for benefits processing. The team has also been working on developing and delivering clinical education series to Delta Dental employees and to external groups and stakeholders. Being the leader in dental insurance, the clinical team is adding clinical bench strength to our company.

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CloseFocusing on Dental-Medical Integration to Help Members Achieve Better Oral and Overall Health

At Delta Dental of Colorado, we mean what we say when it comes to oral and overall health being strongly connected. There are more than 120 diseases that have visible signs that can be detected in the mouth and through health histories taken at the dental office. We understand that inflammation plays a big role in the disease mechanism, and the mouth is absolutely connected to the body. If we can control some of the inflammation from periodontal (gum) disease as well as the caries process (decay), that then relieves part of the burden on the patient’s body to fight the micro-intruders that are common in many disease processes.

Many of our dental benefit designs include enhanced benefits for additional services to treat advanced dental disease in those patients with higher risk for infection and inflammation that would otherwise exacerbate their chronic illnesses, such as diabetes. Additionally, our standard plan designs focus on prevention — exams, diagnostic X-rays, routine cleanings — and minimize or eliminate barriers to those preventive services. With multiple clinicians on our team, Delta Dental of Colorado is able to ensure that benefits make good sense to maintain both oral and overall health and offer up educational materials and seminars to our brokers, consultants, clients, and members.

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