IN Provider Webinar IN Marketplace Launching January 2017

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

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

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:  https://govservices.dentaquest.com/Router.jsp?component=Main&source=Logon&action=ProviderDirectory2&plan=IN|526&locale=en Notes: * DQ anticipates low initial member enrollment. ~200 members

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

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

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.

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

Sample ID Cards- DentaTrust \

Sample ID Cards- DentaSpan \

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.

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

DentaTrust/DentaSpan Low Plans Benefit Overview DentaTrust/DentaSpan Low Plans

DentaTrust/DentaSpan Low Plans

Where do I mail claims? DentaQuest PO BOX 2906 Milwaukee, WI 53201-2906 The Payor ID for electronic submission is: CX014 Providers have 90 days to submit claims to DentaQuest

How do I get more information? DentaQuest’s Customer Service phone number is 844-234-9837 for providers Office Reference Manual- Available 1/1/17 DentaQuest’s website: http://www.dentaquest.com/state-plans/regions/indiana/dentist-page/ DentaQuest’s new provider portal: https://provider.dentaquest.com/providerlogin 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.

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

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 email, we will post to microsite, and provider portal. Questions?