Broker blog from Delta Dental

Tag: teledentistry

COVID-19 by the numbers

The early days of the pandemic brought a tidal wave of changes to the dental industry. As a broker, you know that those shockwaves ripple out to affect your business. Understanding how COVID-19 impacted patients, dentists and the dental insurance industry helps you plan for the future and informs how you can best serve your clients. Let’s take a deep dive into claims data, patient surveys and expert opinions.

The rise of teledentistry

During the early stages of the pandemic in the United States, dental offices were closed to physical appointments for weeks. This led to a massive surge in the popularity of teledentistry services. Synchronous appointments (those with live phone or video interaction between dentists and their patients) saw a 3,000% increase between 2019 and 2020, according to Delta Dental claims during that period. Asynchronous appointments (where patients took photos or videos that were sent to a dentist for later review) saw a 1,000% increase in the same time period.

The use of teledentistry has declined as the pandemic has worn on and dentist offices have reopened, but 2021’s synchronous and asynchronous appointment numbers still remain six times and two times higher than 2019 levels, respectively.

More states also updated their teledentistry laws during the pandemic. Based on Delta Dental’s internal tracking, fourteen states added teledentistry regulations to their laws or expanded existing regulations, including states like Texas that had previously not allowed the practice of teledentistry at all.

Most importantly, in a phone survey of teledentistry patients during the pandemic, patients expressed widespread satisfaction with their options. This aligns with pre-pandemic expectations that patients had about teledentistry, in which 78% of patients surveyed expected to use teledentistry within the next five years. That same group anticipated that working people, children and people with disabilities would benefit the most from teledentistry.

Dentists also had praise for teledentistry, with over 80% of dentists identifying it as useful for improving access to oral care, increasing specialists’ access to rural and underserved communities and as a time-saving technique. Virtual visits may not replace in-person checkups, but they remain a valuable tool for both dentists and patients, and an important consideration for your clients.

Keeping dentists (and you) in business

The beginning of the pandemic was marked by profound economic uncertainty as dental practices closed and people sheltered in place. General practitioner income dropped nearly 18% in 2020 compared to 2019.

Recognizing that without adequate resources dentist offices may be forced to close, Delta Dental was able to assist with loans, reimbursements for personal protective equipment (PPE) costs and free teledentistry tools that allowed dentists to see patients remotely.

Loans offered in partnership with Provide (formerly Lendeavor) allowed dentists to make practice acquisitions, expand to new locations, purchase commercial real estate and equipment, build out their practices and refinance existing practice and commercial real estate debt. These loans featured favorable terms and conditions, such as covered interest for 24 months, deferred payments for 6 months, repayment terms of 10+ years and working capital of up to $200,000.

Delta Dental also offered a supplemental reimbursement for qualifying evaluations and consultations during the second half of 2020. This Return to Care reimbursement led to an additional $80 million for dentists last year to help offset the costs of PPE and office cleanings.

The pandemic saw the rollout of two teledentistry options for Delta Dental members: Delta Dental – Virtual Consult and Toothpic.

  • Virtual Consult is a synchronous service where members can use a smart device to have a live video chat with a Delta Dental dentist.
  • Toothpic is an asynchronous service that allows members to take photos of problem areas and get an assessment from a Delta Dental dentist within 24 hours.

These services are free for members and dentists. Most importantly for your clients, these options expand access to assist patients who may have difficulty making it to in-person visits or prefer a remote appointment.

How patients used their benefits

The early stages of the pandemic saw a drastic decline in the number of patients going to the dentist’s office. One of the main reasons for the decline was that the sharp economic shutdown led to over 20 million Americans losing their jobs (PDF) and their dental coverage as well. Of these 20 million, nearly half found themselves without insurance at all. The remaining jobless got dental coverage through resources like Medicaid.

This decline in visits to the dentist office had a profound effect on patients’ oral health. 

In 2019, the most common procedures according to Delta Dental claims data were either routine preventive care or evaluations for specific issues. This shifted in 2020, when some of the most common procedures were fillings and root planing, which help address the effects of dental neglect.

In addition to the economic hardships COVID-19 brought to patients, COVID also increased mental and emotional strain. Since the pandemic began, the number of adults reporting symptoms of anxiety or depressive disorders has risen from about 10% to over 40%.

These symptoms can manifest in jaw clenching and teeth grinding; based on Delta Dental claims data, the number of patients requiring occlusal guards to prevent damage rose nearly 10% in the second half of 2020 compared to the same period in 2019. 

Anxiety and depression can also worsen an unhealthy diet or substance abuse, which can lead to oral health issues such as cavities. This may also help to explain the surge in fillings and scaling and root planing procedures in 2020.

Health and safety in the dental office

Even though COVID-19 is spread by exhaled aerosolized droplets, visits to the dentist’s office proved safer than visiting any other medical professional during the pandemic. Nearly 100% of dentist offices rapidly adopted enhanced infection control measures like pre-appointment screenings, in-office air purification and antiviral mouthwashes. Once vaccines became available, they saw widespread adoption amongst dentists, even before state and federal mandates. By the second quarter of 2021, over 90% of dentists had received at least one vaccination shot for COVID-19.

Patients also view dentists as valuable sources of information about their overall health in addition to their oral health. Two-thirds of dentists reported receiving questions from patients about the COVID-19 vaccine (PDF), according to the ADA. 

Dentists rose to the occasion, with over 80% reported feeling prepared for these discussions and 95% believing it was important to have such discussions with patients.

What did we learn from COVID-19?

Here are three key takeaways for you and your practice as you look to the future.

  • Encourage group clients to choose plans that truly meet their needs. A “Cadillac” insurance plan can be an attractive proposition for you and your clients, but it may be more coverage than they need. Conversely, in periods of economic uncertainty, individuals may decide that they should forego dental insurance entirely, but this can lead to small issues going untreated and becoming major ones. Helping your group and individual clients identify a plan that fits their needs (and their wallets) early on can go a long way towards keeping them healthy and happy no matter the economic forecast.
  • Foster relationships with individual clients that are about more than just sales. One thing COVID-19 showed was that in the face of uncertainty, people were desperate for answers. As an insurance industry expert, you can be well-suited to advise your clients and help them identify their needs, choose a plan that fits and seek care. Being able to offer advice on wellness and on current topics, such as the safety of vaccines, can go a long way towards building lasting relationships with your clients.
  • Have a resiliency plan in mind in case of an economic downturn.  The pandemic demonstrated that massive disruptions to the way we do business and live our lives aren’t just a possibility but an inevitability. Even if we don’t see another global pandemic within our lifetimes, there will undoubtedly be more localized disruptions from natural disasters like hurricanes, major storms and wildfires. Diversifying your client base (such as by selling to individuals if you currently focus on group clients) can help you to weather periods of economic uncertainty.

New teledentistry options: Toothpic and Virtual Consult

Two new teledentistry options have come to Delta Dental PPO™ and Delta Dental Premier® plans. Say hello to Toothpic and Delta Dental – Virtual Consult.

Utilizing these options doesn’t require any changes to the way members use or pay for their benefits. Instead, it’s a new way for members to use existing plan benefits — remotely. These new tools are an ongoing covered benefit and have no additional administrative costs or access fees for Delta Dental clients or members.1 When members use either of these tools, they can rest easy knowing that they’ll be connected with a licensed Delta Dental dentist they can trust.

Toothpic

Toothpic is a secure HIPAA-compliant app that provides a photo-based virtual dental screening from anywhere you have a smart device and an internet connection. It’s perfect for those who want a dental checkup with a Delta Dental dentist without an appointment. Toothpic lets members:

  • Get evaluations on their own schedule by submitting pictures of their mouth, teeth and gums
  • Receive a personalized in-depth report from a Delta Dental dentist within 24 hours
  • Check in for diagnoses on areas of concern and get info about their next steps 

Virtual Consult

Virtual Consult is a secure HIPAA-compliant video-based tool for having a virtual appointment with a dentist. It’s ideal for those who have urgent oral care needs, like pain or a cracked or chipped tooth, and want to speak directly with a Delta Dental dentist. With Virtual Consult, members can:

  • Schedule and have a video appointment with a Delta Dental dentist without leaving home
  • Have quick, real-time consultations on urgent issues even if they don’t have a dentist they see regularly
  • Get an e‑prescription and aftercare instructions for pain or infection

Virtual dentistry allows members to receive a diagnosis from the comfort of their own home. Whether they’re just looking for a quick check-in or have an urgent concern, these teledentistry options can help them meet their needs with all the ease telehealth offers.

1. Members who have 100% coverage for oral evaluations and who have not exceeded their frequency limitations for office visits or limited oral evaluations are eligible to use Toothpic and Virtual Consult. Using Toothpic to receive a diagnostic report or using Virtual Consult for a remote visit each count as one office visit/oral evaluation for the purpose of frequency limitations.

5 ways Delta Dental is responding to the COVID-19 pandemic

Delta Dental is working to support our customers, dentists and local communities during the COVID-19 pandemic. Here are some of the ways we’re responding to this health and financial crisis.

1. Charitable giving to vital services

The Delta Dental Community Care Foundation has provided nearly $15 million this year to help nonprofits respond to the pandemic. These unrestricted grant funds have supported essential services, including dozens of dental and medical clinics serving low-income communities across our 15-state service area and the District of Columbia.

To help feed vulnerable communities during skyrocketing food insecurity, we’ve also contributed $2.5 million to food banks in Alabama, California, Delaware, Florida, Georgia, Louisiana, Maryland, Mississippi, Montana, Nevada, New York, Texas, Utah, West Virginia and the District of Columbia.

2. Dentist loan program

Partnering with Provide (formerly known as Lendeavor), Delta Dental has offered over $300 million in loan programs to provide economic relief for qualifying independent network dentists.

The loan program, which extends through the end of the year, covers cash flow relief as well as interest savings. It also includes loans that dentists can use to acquire, refinance, expand or equip a practice, as well as to acquire or refinance commercial real estate for a practice.

3. Relief for groups, individuals and brokers

We’ve offered various forms of premium relief to all lines of our business to help alleviate the financial strain of the pandemic on our individual customers and group clients. To provide further support, we’ve made adjustments to many of our contract policies to help clients and brokers weather the financial impact of the pandemic.

At the same time, we’ve also prioritized our brokers’ financial stability. Commissions have remained intact, with no reductions to offset premium relief.

4. PPE and infection control reimbursement for dentists

The new costs of practicing during a pandemic have added to the financial strain on our network dentists. To help, Delta Dental launched a supplemental reimbursement program for network dentists.

The temporary program, which runs through the end of the year, is meant to help dentists adjust to the new conditions under COVID-19 as they plan for 2021. Under the program, network dentists receive an additional $10 per patient per qualifying service to help cover the costs of additional personal protective equipment and other infection control practices.

5. Teledentistry resources

Delta Dental has encouraged dentists and patients to consider teledentistry options for diagnostic and emergency dental services. Teledentistry, or virtual consultation via phone, text or video, offers a safe, convenient choice and can expand access to care for patients who might otherwise not see a dentist.

We’re offering discounts and free trials on HIPAA-compliant teledentistry services to Delta Dental dentists and are building partnerships with teledentistry companies to improve the experience for our customers and network dentists.

How has COVID-19 affected the dental industry?

The new coronavirus (COVID-19) pandemic has significantly altered how the dental industry operates. Here are three ways the pandemic has changed the dental insurance landscape.

Timid patients

There’s an almost daily debate of what constitutes a good reason for leaving your house right now. Individual states are at different stages of re-opening or shutting back down. With so much uncertainty, it makes sense that 42% of patients respondents may skip or postpone care out of fear or discomfort, particularly for non-emergency procedures.

This on top of the 61% of people who already suffer dental fears means that showing patients the extensive infection control measures in place may be an important aspect of getting them back in the chair.

A boom in teledentistry

Teledentistry is a way for dentists to provide a virtual consultation through a phone call, text, or video chat. Dentists can use teledentistry to address problems that don’t need an office visit, which allows them to save time and money on infection control measures like personal protective equipment and sanitizing office spaces. This gives practices an ideal way to assess and triage patients without a risk of exposure, while also potentially allowing a dentist to see more patients in a day.

Even before the pandemic, teledentistry was showing itself as an interesting and promising addition to traditional dental care. It allows dentists to see patients who are at-risk, live in rural areas, or those who just desire the convenience as well as potentially decreasing costs of dental care overall.

The key ingredient to the success of teledentistry is widespread patient acceptance. One possible issue, according to a review of survey’s about teledentistry, is that patients may feel like the quality of care received remotely is not as high as care received in person. However, users in one study were generally satisfied with the experience and respondents in another survey indicated that they would use teledentistry if it was available.

Americans losing health insurance

The biggest shift has been in the number of people with access to health insurance. With millions of jobs lost, many individuals and their families have lost both their coverage from their employers as well as a steady income. According to researchers from the Urban Institute, some individuals will be able to become insured under a family member’s policy, through the Affordable Care Act marketplace, Medicaid or by choosing individual coverage through a broker. Still, that leaves almost 3.5 million people who may become uninsured. With the end of federal programs to support those who have lost their jobs, one big question for the dental industry is whether or not people will make the choice to go to the dentist.

Teledentistry: what it is, and what it means for your clients

Businesses, schools and public space have been reopening for months now, and that includes dental offices. As part of the reopening efforts, more dentists and their patients have turned to teledentistry, an emerging trend that has the power to reshape the industry as we know it. Here are some common questions about teledentistry, as well as our thoughts about the impact teledentistry will have on the industry and how Delta Dental is addressing it.

What is teledentistry?

Teledentistry is when a dentist conducts a virtual consultation via phone, text or video to diagnose issues, offer care advice and determine if an in-person visit is necessary.

Teledentistry appointments can be synchronous, such as a video call where the dentist and patient are interacting with each other, or asynchronous, such as when the patient sends a description of his or her situation and a photo and waits for a reply.

Are teledentistry appointments covered by insurance?

Yes. Delta Dental covers teledentistry services as problem-focused exams. That means they fall into the category of diagnostic care, and are subject to the same rules and limitations (for example, D&P is usually covered at no cost to the patient, but only a certain number of such appointments are covered each year).

What kind of equipment is needed for teledentistry appointments?

The equipment and software needed may vary based on dentists’ preferences and capabilities. Teledentistry may require nothing more than a phone or may require a smart device, computer or specialized app.

If dental offices are reopening, why is teledentistry relevant?

Dentist offices may open, but that doesn’t mean that patients won’t benefit from teledentistry solutions. Just as working from home has shown the value of video meetings and connecting with coworkers without being in person, patients may find teledentistry a useful option when seeking dental care.

Additionally, not all patients are willing to return to the dentists. Surveys this past August by the American Dental Association (ADA) have found that 15% of people are waiting for a medical breakthrough such as a vaccine before they’ll go back to the dentist. Whether your clients are eager or hesitant to return the dentist, teledentistry is the perfect tool for staying in touch, getting care and getting advice without going into the dentist’s office.

What is Delta Dental doing with regards to teledentistry?

Delta Dental covers teledentistry appointments at the same benefit levels as diagnostic services to ensure that enrollees have coverage for their dental needs while staying safe from COVID-19. We’re encouraging dentists to use teledentistry for emergency diagnoses and non-emergency consultations. Delta Dental dentists are also eligible for discounts on teledentistry services. What’s more, Delta Dental is looking into partnerships with teledentistry companies to improve the experience for both dentists and their patients.

How will teledentistry change the industry?

COVID-19 has been disruptive to the entire economy, and the dental industry is no exception. That disruption is more than just economic, however. Expectations about what it means to go to the dentist are also changing. Dental patients may expect teledentistry to be included as a standard part of any insurance plan (for example, Kaiser Permanente is launching plans with a heavy focus on telehealth) and they may shy away from plans and dentists that can’t accommodate it. Patients who live in remote areas may also find expanded access to professional care because of teledentistry.

For dentists, teledentistry is more than just another option or add-on when it comes to providing care and in-person treatments. It may become a new source of income in the form of seeing more patients virtually.

For brokers, staying on top of the latest developments, industry best practices and customer expectations about teledentistry will become ever more important.

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