MDA News April-May 2008

Proper Disposal of Hazardous Waste and Amalgam Wastewater Issues

To help MDA members understand and follow the optimal practices for handling amalgam waste and other hazardous materials, MDA developed and distributed a guide to all its members, including the ADA's Best Management Practices for Amalgam Wastes, guidelines from MDA on handling and recycling hazardous materials, and a self-assessment form for use by dental offices.  MDA encourages its members to safely recycle all hazardous waste generated by a dental office.

MDA and the dentists in the Second District formed a coalition with the Missoula Wastewater Treatment Plant, Missoula county City-County Health Department, Montana Department of Environmental Quality, and Women's voices for the Earth, a non-profit environmental group, to encourage dentists to recycle amalgam waste.  The group worked collaboratively to develop a pilot project called WATER, Waste Amalgam Treatment, Education, and Recycling.  The program is modeled after the American Dental Association's best management practices (BMPs).  Missoula dentist Dr. Jackie Jones and Second District president Dr. Ryan Huckeby represented MDA's interests in this collaboration.

 

Access to Baby and Child Dentistry

Led by Dr. Jane Gillette, a group of MDA dentists that includes Dr. Don Nordstrom of Missoula, Dr. Kevin Rencher of Helena, Dr. Roger Newman of Columbia Falls, and Dr. Mike Bowman of Kalispell, promoted the creation of the ABCD [Access to Baby and Child Dentistry] program in Montana.  ABC focuses on preventive and restorative dental care for Medicaid-eligible children from birth to age six, with emphasis on enrollment by age one.  It is based on the premise that stating dental visits early will yield positive behaviors by parents and children.  The program encourages dentists to begin seeing children as soon as the first teeth emerge and provides training to dentists in early pediatric dental techniques.  Dentists serving this population will receive enhanced fees for their services.  The program is modeled after the successful program in Washington State.  MDA is seeking funding from the State of Montana to establish this program across the state.

 

Montana Dentists Donate Generously in Sixth Annual GKAS

MDA members and their staff across Montana donated more than $150,000 in free care to Montana children during the sixth annual ADA-sponsored “Give Kids a Smile” event in early February.  This was the largest amount of donated care in the six years that MDA members have been participating in this annual event.  Dentists in large and small communities set aside one day each year to treat Montana’s children at no cost.  In several communities GKAS activities extended throughout the month.

 

MDA Board Names New Dentist Member from Helena

When the term of MDA Board member Dr. Jeffrey Dalen of Whitefish ends at the 2008 annual meeting, Dr. Jaden Erwin of Helena will assume the role of representing new dentists on the MDA Board of Directors.  Dr. Erwin was selected by the Board at its March meeting and will serve for one year with the opportunity to apply for a second year.  He graduated form the University of Montana in 2001 and University of Washington School of Dentistry in 2005.  While in dental school he worked as the “Give Kids a Smile” coordinator for the school.

 

MDA Health and Well-Being Committee

Guided by their chair, Dr. Terry Zahn of Missoula, members of the newly-created MDA Health and Well-Being Committee began to develop a peer assistance program for MDA members called the "MDA Member Assistance Program".  The program offers help to members who may be struggling with alcohol, substance abuse, or mental health problems.   

 

Medicaid Dental Rates Rise

Thanks to increases gained during the 2007 Montana Legislature, dentists' reimbursement rates have increased effective October 1. The new fee schedule can be viewed as a web page or Excel file. According to the Montana Department of Public Health and Human Services (DPHHS), the rate increase brings Medicaid reimbursement up to 85% of billed charges in the aggregate, as those charges have been submitted to DPHHS in the past. The child and adult rates have been combined into one rate. Expanded coverage also is now available for the procedure codes that apply to porcelain fused to base metal crowns for anterior or posterior teeth, following approval through the prior authorization process.

In other news from DPHHS, beginning April 1, 2008, dental providers submitting paper claims will be required to use an ADA dental claim form with a copyright date of 2006 or later. The Department has instituted this change to standardize claim information and allow the Department to use ACS's optical character recognition system to process dental claims. The new requirement is intended to increase the efficiency of paper claim processing.

If you have questions or for additional information, contact Jan Paulsen, DPHHS Dental Program Officer, at (406) 444-3182 or ACS Provider Relations at 1-800-624-3958.

 

MDA Urges Members to Join Treasure State Dental Plan

MDA's Board of Directors has endorsed a new Direct Reimbursement plan called "Treasure State Dental" which includes direct assignment as a way to promote the program to dental patients.   MDA leadership is committed to expanding the DR model of payment for dental services across Montana.  The Treasure State Dental plan was designed by MDA's insurance consultants at Mountain West Benefit Solutions, who market the Direct Reimbursement program.   MDA president, Dr. Roger Newman, comments, "One of the top priorities of my year as president is to expand DR and our new direct assignment program to all four corners of the state.  We hope 100% of Montana's practicing dentists will sign up with the Treasure State Dental plan."

What is the Treasure State Dental Plan?

• A dental benefit plan in which patients are reimbursed a percentage of their expenses based on the dollars spent rather than a class of procedure codes.
• The employer determines the percentage of reimbursement and maximum benefit per year.
• All procedures, except cosmetic, are eligible expenses.
• There is no insurance company involved.  Insurance is unnecessary due to the predictability of claims, low utilization and plan maximums.

What are the advantages for the employer?

• Employers can design a plan that fits their budget and the needs of their employees.
• None of the dollars spent by the employer are going to an insurance company for risk, retention, premium tax, and profit.  This means more dollars are available to pay employee dental benefits.
• The employer is able to control costs through plan design and adjusting the annual maximum.
• The simplicity of Treasure State Dental makes the program ideal for employer self-administration or a third party administrator.  Using either approach results in rapid claim payment and happy employees.

What are the advantages for the employee?

• Employees have the freedom to choose any licensed dentist.  There is no provider network and no need to switch dentists when the plan changes from one insurance company to another.
• Employees generally do not have restrictions on the types of procedures covered or frequencies of needed treatment.
• Pre-authorization is not required so treatment is not delayed.
• Employees have the freedom to plan the appropriate treatment for their dental needs with no outside interference.
• Employees may spend the dollars in their benefit plan as they choose.

To sum up...

With Treasure State the employer can design a dental plan to meet the employee’s needs while meeting the company’s financial goals.  The employee can select any dentist and spend the claims dollars as they choose without outside interference.  This is one of the best examples of consumer driven health care working as intended.

The Treasure State Dental plan eliminates the middleman, maximizes patient choices and benefit dollars, while allowing the employer to maintain control.  Dentists also embrace the approach because it doesn't interfere with the doctor-patient relationship.

To learn more, contact
MDA at 1-800-257-4988 

or

Treasure State Dental
1 N. Last Chance Gulch, Suite 3
Helena, MT  59601
Fax  (406) 442-1913
sharne@mwbs-insurance.com

 

MDA Launches Mentorship Program

Under MDA's new mentorship program, MDA dentists who have been in practice for a few years will be asked to offer advice and guidance to the association's newest members.  The new dentist members of MDA have expressed a strong desire to learn more about the business side of running a dental practice.  Through mentoring, experienced members will draw upon their personal and professional lives, to answer the multitude of questions new dentists face at the prospect of practice management.

If you have been in dental practice several years and are willing to act as a wise and trusted counselor to a young dentist, please contact the MDA at 1-800-257-4988 or mda@mt.net to ask about becoming a mentor.  You will be asked to complete a brief form that will be used to make the best match between you and a new dentist.  MDA also will offer you tools and information to get you started as a mentor and will act as a valuable resource as you develop this important relationship.

 

Handling Dental Amalgam Waste

Dental amalgam can be recycled to help prevent the release of mercury to the environment.  The ADA has developed Best Management Practices for Amalgam Waste.  To obtain a copy of the BMPs, link to www.ada.org/prof/resources/topics/topics_amalgamwaste.pdf .

Members of MDA are encouraged to follow the steps suggested by ADA for recycling amalgam waste.

The ADA has prepared a directory of amalgam recyclers that is available on the ADA website at www.ada.org/prof/resources/topics/topics_amalrecyclers.pdf .  Also, to further assist its members, MDA offers the following information about several companies that manage amalgam waste.  This information is offered for informational purposes and should not be used as a substitute for a dentist's own evaluation of a prospective amalgam recycler.

1. Safety-Kleen Systems (serves western Montana)
   9516 E. Montgomery, #19
   Spokane, WA  99206
   Telephone: 509-928-8353
   www.safety-kleen.com
   
   Safety-Kleen Systems (serves eastern Montana)
   3704 Saratoga Avenue
   Bismarck, ND  58503
   Telephone: 701-222-8262
   www.safety-kleen.com
   
   Safety-Kleen offers a pick-up service for dental amalgam waste, contact and non- contact.  Waste amalgam, along with waste from chairside traps and vacuum filters, is collected and placed in DOT-EPA-approved storage containers and necessary labeling is provided.  When the container is full a service representative will remove and replace the container.  This pickup service is offered in most Montana cities and towns. Safety-Kleen also offers a pick-up service for photo fixer/developer and waste lead and lead foil.  They offer a mail-back service for biohazard sharps.  A company representative will come to your office to explain their recycling program.

2. Maguire & Stickland
   1290 81st Avenue NE
   Minneapolis, MN  55432
   Telephone: 800-486-2858
   http://www.maguireref.com/
   
   
   Strickland supplies a prepaid amalgam waste package.  They accept contact and non-contact dental amalgam, soft and hard plastic amalgam traps, and teeth with amalgam. When the container is filled, you call UPS for pick-up. Strickland prepays for shipping charges.  Amalgam need not be sterilized.

3. Mercury Waste Solutions, Inc.
   21211 Durand Avenue
   Union Grove, WI  53182
   Telephone: 800-741-3343
   
   Mercury Waste Solutions, Inc. accepts contact and non-contact amalgam. Contact amalgam must be disinfected.

4. Amalgaway
   3672 East Raymond Street
   Indianapolis, IN  46203
   Telephone: 800-267-1467
   
   They accept contact and non-contact amalgam.  It need not be sterilized.

5. Sure-Way now picks up Amalgam in small amounts
   
   In an effort to meet the needs of their customers, Sure-Way has worked with the State of Montana to develop program to pick-up amalgam waste in quantities as small as 1 cup. This new service will be coordinated with the company's medical waste services. The waste will be separately manifested to demonstrate that the dental office is properly disposing of mercury amalgam waste. There will be no additional pick-up charge so long as medical waste is picked up at the same time. For information about the new service, contact the company at email address: garywayyn@aol.com.
   
   
6. Garfield Refining Company
   810 E. Cayuga Street
   Philadelphia, PA 19124 USA
   Phone: 800-523-0968
   Fax: 215-533-5902

 

 

Montana Dental Association
P.O. Box 1154
Helena, Montana 59624

E-Mail: mda@mt.net
800-257-4988 (In Montana only)
406-443-2061 (in the Helena area)
Fax: 406-443-1546