Dental Health Plan Initiatives Dr. Larry Paul, DDS Dental Director, - - PowerPoint PPT Presentation

Dental Health Plan Initiatives

• Dr. Larry Paul, DDS

Dental Director, Keystone First September 21,2013

Beyond Your Smile Program

• A collaborative medical/dental relationship
• Dentists serve as an additional point of contact for members
• Dentists will be trained to provide specific screenings for targeted

members

• Screening results are sent to the primary care provider for follow-

up care

Screenings Included

• Blood Pressure (for members over 12 years of age)
• BMI (for members over 12 years of age)
• Hemoglobin A1c (for members who have not seen their primary

care physician in six months)

• Cholesterol LDL/HDL (for member who have not seen their

primary care physician in six months)

Beyond Your Smile Process

Participating Dentists are:

• Provided with access to NaviNet to identify members with care

gaps

• Supplied with LabCorp Hemoglobin A1c and Cholesterol test kits
• Provided with the Beyond Your Smile screening form
• Provided with pilot area PCP contact information
• Trained on submission of a CMS-1500 form

Beyond Your Smile Pilot

• Pilot in Chester, Pennsylvania
• Five participating dental practices
• 11,000 Keystone First members
• Identify non-compliant diagnosed members
• Close care gaps
• Diagnose the undiagnosed