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Active Duty Dental Program

Active Duty Dental Program

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Active Duty Dental Program

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  1. Active Duty Dental Program MAJ Mary-Frances McBain Health Services Officer, ARNG NGB-ARS 29 Jun 09

  2. Agenda • Purpose • What is Active Duty Dental Program (ADDP)? • Geographical Areas of Service • Claims • Steps to Accessing Care • Appealing a Bill • Tutorial • Summary • Conclusion MAJ McBain / NGB-ARS / 703-607-9066 / mary.mcbain@ng.army.mil

  3. Purpose To familiarize Leaders and Soldiers with the new process to access dental care under the Active Duty Dental Program MAJ McBain / NGB-ARS / 703-607-9066 / mary.mcbain@ng.army.mil

  4. What is ADDP? (1 of 2) • Beginning 1 Aug 09, the ADDP will provide authorized private sector dental benefits under two distinct components for ARNG Soldiers • ADDP is available to Soldiers who are either • referred from a Dental Treatment Facility (DTF), • or reside and work outside the catchment area • duty location > 50 miles from a military DTF under the Remote Active Duty Dental Program (Remote ADDP) • Line of Duty (LOD) care will also fall under this program MAJ McBain / NGB-ARS / 703-607-9066 / mary.mcbain@ng.army.mil

  5. What is ADDP? (2 of 2) • The ADDP is designed to augment, not replace, dental care provided in military DTFs • United Concordia pays dentists for authorized dental care • Treatment must be provided by a United Concordia network dentist in order to be eligible for payment, unless otherwise designated by the Department of Defense (DoD) • Replaces Military Medical Support Organization (MMSO) Dental Program, effective 1 Aug 09 MAJ McBain / NGB-ARS / 703-607-9066 / mary.mcbain@ng.army.mil

  6. Geographical Areas of Service • Dental care under the ADDP will be available in the United States, U.S. Virgin Islands, Guam, Puerto Rico, America Samoa, and the Northern Mariana Islands • United Concordia offers an extensive dental provider network of more than 59,000 dentists nation-wide MAJ McBain / NGB-ARS / 703-607-9066 / mary.mcbain@ng.army.mil

  7. Claims • United Concordia’s network of over 59,000 dentists will submit ADDP claims to United Concordia for payment • All ARNG Soldiers eligible for the ADDP program must receive dental care from a United Concordia network dentist to be eligible for payment • Claims will be paid for those areas where there are no available network dentists as determined by United Concordia MAJ McBain / NGB-ARS / 703-607-9066 / mary.mcbain@ng.army.mil

  8. Steps to Accessing Care (1 of 4) • Remote ADSMs may personally coordinate their routine covered dental procedure as long as the dental treatment is less than $500 per procedure or appointment or the cumulative total is less than $1,500 for treatment plans completed within a consecutive 12-month period • To coordinate their routine dental care, remote Soldiers must get an Appointment Control Number (ACN) by completing an Appointment Request Form, prior to seeking care MAJ McBain / NGB-ARS / 703-607-9066 / mary.mcbain@ng.army.mil

  9. Steps to Accessing Care (2 of 4) • Soldiers go to the following website to access the appointment request form: • www.addp-ucci.com • There are two options for Soldiers wishing to schedule appointments • United Concordia Dental Care Finders can make the appointment for Soldiers if they select United Concordia in the “who will be responsible for scheduling this appointment” field on the form • Soldiers can personally make an appointment with a United Concordia network dentist by selecting the ADSM option in the “who will be responsible for scheduling the appointment” field on the form MAJ McBain / NGB-ARS / 703-607-9066 / mary.mcbain@ng.army.mil

  10. Steps to Accessing Care (3 of 4) • It is important for Soldiers to remember they must wait until they receive the ACN from United Concordia before they can make their own appointments • Additionally, making their own appointment requires a Soldier to Contact United Concordia with the dentist’s name, date and time of the appointment so their records may be updated • Soldiers can do so by e-mailing United Concordia at addpdct@ucci.com or calling 1-866-984-ADDP (2337) • If a Soldier has difficulty getting an appointment within 21 days of request they need to contact United Concordia at 1-866-984-ADDP (2337) • Soldiers can choose to wait more than 21-days for a specific provider and waive their right to an appointment within the required 21-days, if they choose MAJ McBain / NGB-ARS / 703-607-9066 / mary.mcbain@ng.army.mil

  11. Steps to Accessing Care (4 of 4) • Specialty and other Private Sector Dental Care • To receive treatment for specialty care or care over $500 or $1,500/12 consecutive months, Soldiers MUST have their provider: • Go to the ADDP website • Fill out the Authorization Request Form in the Civilian Dentist portal for electronic completion and submission by the dentist • Upon authorization both the dentist and Soldier will be notified and an appointment can then be scheduled • The determination of the authorization request can take from three to five business days MAJ McBain / NGB-ARS / 703-607-9066 / mary.mcbain@ng.army.mil

  12. What to do if a Soldier Receives a Bill? • If a Soldier receives a bill for failure to go to a United Concordia Network Provider: • The Soldier may appeal the bill at: Appeals United Concordia Companies, Inc. ADDP Unit – Appeals P.O. Box 69430 Harrisburg, PA 17106-9430 MAJ McBain / NGB-ARS / 703-607-9066 / mary.mcbain@ng.army.mil

  13. United Concordia • United Concordia set-up web based tutorials available for Soldiers, units, and other POCs to become familiar with the new processes • https://secure.addp-ucci.com/ddpddw/adsm/tutorials.xhtml MAJ McBain / NGB-ARS / 703-607-9066 / mary.mcbain@ng.army.mil

  14. Summary • As of 1 Aug 09, the MMSO is no longer coordinating remote dental care • Soldiers with LOD needs or in Remote Service Areas must use a United Concordia network provider for their dental needs as of 1 Aug 09 • Leaders, units and TRICARE POCs can go to www. addp.ucci.com to obtain training on this new program MAJ McBain / NGB-ARS / 703-607-9066 / mary.mcbain@ng.army.mil

  15. Conclusion • This is a new program, and with any new program, there will be growing pains • Please be patient with United Concordia as they grow with the Army National Guard as our newest team member MAJ McBain / NGB-ARS / 703-607-9066 / mary.mcbain@ng.army.mil

  16. Active Duty Dental Program MAJ Mary-Frances McBain Health Services Officer, ARNG NGB-ARS 29 Jun 09