When it comes to oral health, we know that some people need more care than others. That's why Delta Dental of Oregon offers Health through Oral Wellness®, a program that clinically assesses the oral health of patients and offers extra benefits to patients who are at greater risk for oral diseases. Health through Oral Wellness helps you provide care that leads to better oral health for your patients.
Dental benefits are most effective when they are personalized and linked to evidence-based benefits and care. By helping your at-risk patients get the care they need, Health through Oral Wellness helps your dental practice:
Are you getting all the benefits that the Health through Oral Wellness program has to offer? Watch this short video to learn how the PreViser risk assessment tool can help bring extra revenue to your practice while accessing enhanced benefits for your at-risk patients.
The enhanced benefit feature of Health through Oral Wellness is available to patients whose employer participates in the program. In order for your at-risk patients to get the extra benefits and related care they need, you must be signed up for the program.
After performing a clinical oral health assessment for your patient, their results will be scored by PreViser™, a third-party online application that performs a dental risk and periodontal disease analysis. Patients that score between 3-5 may be eligible for enhanced benefits. Additional benefits may include extra cleanings, fluoride treatments, oral hygiene or nutritional counseling, sealants and periodontal maintenance.*
*All enhanced benefits are subject to the patient meeting their plan's annual maximum and other limitations.
Depending on the employer's group policy, a risk assessment must be performed at every routine re-care visit to occur at least once in the plan year. Enhanced benefits and standard policy requirements, including coinsurance percentages, copayments and plan maximums, may be subject to change.
Health through Oral Wellness is a unique, patient-centered program that encourages an open, collaborative patient-dentist relationship. By taking a simple risk assessment and seeing their dentist for oral care based on their individual needs, members can take charge of their oral health. If their oral health risk scores show them to be at greater risk of tooth decay or gum disease, they may qualify for enhanced dental benefits. As part of this program, dentists also perform an oral cancer risk assessment.
After completion of the clinically validated oral health risk assessment by a dentist who has registered for the program, PreViser uses a set of algorithms to determine the patient's risk score. If a patient's risk score is between 3-5, they are eligible to receive additional dental benefits. All enhanced benefits are subject to the member's plan maximum and other limitations. Additional benefits include extra cleanings, fluoride treatments, oral hygiene or nutritional counseling, sealants and periodontal maintenance based on their risk for oral disease.
Delta Dental collects and securely stores your patient's oral health risk assessment data and other personal information to improve our ability to help us communicate with your patients and their family about oral health. We also use the data to help us improve the benefits we provide to help you deliver the oral care they need. The information you share allows us to communicate with them based on their individual oral health status and personal preferences. Oral health risk assessment scores submitted by you may authorize enhanced benefits for members at greater risk for oral diseases like tooth decay and gum disease. Delta Dental may use de-identified data to generate reports, analyses or educational materials as needed to improve plan designs, wellness offerings and educational materials.
Your patient's oral health risk scores are never shared with their employer. Your data is securely stored in a HIPAA compliant data hub called the Prevention Management Console or PMC which is located behind Delta Dental's firewall. Access to information stored in the PMC is authorized only for the purpose of improving dental plan designs, wellness offerings and educational materials; to provide members with the oral health information and resources they request; and to authorize enhanced benefits based on the individual's risk for oral disease. As with claims data, information in the PMC can be used to generate trend analyses, reports and educational materials. Data used for these purposes will always be de-identified. Persons who are granted access to see individual oral health data may do so only for the purposes of assisting members in getting information or services needed to maintain or improve their oral health.
You must perform a risk assessment at least once in the plan year. Reassessing your patients within this timeframe allows them to remain on their groups enhanced benefits plan. Members who are not reassessed within 12-14 months may be reassigned to their standard benefit plan.
Yes. To find out if they are eligible, family members covered on your patients' dental plans may request a clinical assessment by their dentist to determine if they are at a greater risk of oral diseases. Their personal risk scores will determine whether they qualify for extra benefits.
After entering your patient's oral health risk assessment results on the PreViser application, you will receive an instant notification in Benefit Tracker letting you know if your patient is eligible for enhanced benefits. Based on their individual needs, you can determine and discuss the best care treatment plan with your patient during the same appointment.